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Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
Extracranial lower cranial nerve sheath tumors.
J P Leonetti1, B Wachter, S J Marzo
1Center for Cranial Base Surgery, Department of Otolaryngology-Head and Neck Surgery, Stritch School of Medicine, Loyola University Medical Center, 2160 S First Ave., Maywood, IL 60153, USA. jleonet@LUMC.edu
Summary
Lower cranial nerve sheath tumors present with subtle symptoms, often diagnosed at large sizes. Surgical resection via lateral skull base techniques ensures safe and complete removal.
Area of Science:
- Neurosurgery
- Otolaryngology
- Skull Base Surgery
Background:
- Lower cranial nerve sheath tumors (LCNS Ts) are rare neoplasms.
- These tumors often grow slowly in the infratemporal fossa, leading to delayed diagnosis.
- LCNS Ts can present with significant mass effect before detection.
Purpose of the Study:
- To review the clinicoradiographic features of lower cranial nerve sheath tumors.
- To outline surgical approaches for safe and complete resection of these tumors.
Main Methods:
- Retrospective analysis of 13 patients with infratemporal fossa LCNS Ts treated surgically (7/88–10/99).
- Data collected included clinical presentation, radiographic findings, intraoperative details, histology, and outcomes.
Main Results:
- Common symptoms included neck pressure and voice changes.
- Palatal fullness and vocal cord paralysis were frequent signs.
- Lateral skull base approaches were used for all tumor resections, with dysphagia as the most common sequela.
Conclusions:
- LCNS Ts in the infratemporal fossa often reach large sizes due to slow growth and silent location.
- Contemporary lateral skull base techniques provide safe and effective surgical removal.
- Control of the internal carotid artery is crucial for successful resection.
