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

It is very challenging to expose and remove tumors above the hard palate in the retrostyloid space using the typical cervical approach. Other approaches, such as the cervical-parotid approach, may result in prominent scars, facial paralysis, or masticatory dysfunction. Here, we report a case of a vagal neurofibroma between the internal carotid artery and internal jugular vein in the retrostyloid space. We used a 3D model to design a surgical approach that reduced the risk to the surrounding vessels and nerves. We performed an endoscope-assisted resection of the tumor using a posterior styloid approach. Following surgery, there were no obvious scars on the face or neck, facial paralysis, or dysphagia, but mild hoarseness.