Endoscope-Assisted Resection of a Vagal Neurofibroma Using a Posterior Styloid Approach

Area of Science:

• Neurosurgery
• Head and Neck Surgery
• Surgical Oncology

Background:

• Tumors in the retrostyloid space, particularly those above the hard palate, present significant surgical challenges.
• Conventional cervical and cervical-parotid approaches carry risks of disfigurement and functional deficits like facial paralysis and masticatory dysfunction.

Observation:

• A case of a vagal neurofibroma was identified in the retrostyloid space, situated between the internal carotid artery and internal jugular vein.
• A 3D model was utilized to meticulously plan a surgical strategy aimed at minimizing risks to adjacent neurovascular structures.

Findings:

• An endoscope-assisted resection was performed using a posterior styloid approach, providing clear visualization and access to the tumor.
• The surgical procedure resulted in complete tumor removal without causing facial paralysis, dysphagia, or significant scarring.

Implications:

• The posterior styloid approach offers a viable, minimally invasive alternative for resecting retrostyloid space tumors.
• This technique potentially reduces surgical morbidity, preserving facial and laryngeal function while achieving oncological goals.