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[Huge skull base neurofibroma: case report]
T Matsuyama1, T Shimomura, K Kawata
1Department of Neurosurgery, Seikeikai Hospital, Osaka, Japan.
No Shinkei Geka. Neurological Surgery
|June 1, 1996
Summary
This case report details the successful surgical removal of a large skull base neurofibroma using a combined approach. The advanced surgical technique allowed for complete resection of the complex tumor.
Area of Science:
- Neurosurgery
- Oncology
- Skull Base Surgery
Background:
- Neurofibromas are benign tumors that can develop on nerve sheaths.
- Large skull base neurofibromas pose significant surgical challenges due to their complex anatomical location and potential for extensive invasion.
Observation:
- A 32-year-old female presented with left facial paresthesia and deformity.
- Imaging revealed a massive neurofibroma involving the infratemporal fossa, parapharyngeal space, middle fossa, and cavernous sinus, compressing adjacent neural structures.
- The tumor originated from the second branch of the trigeminal nerve.
Findings:
- The patient tolerated trial balloon occlusion of the left internal carotid artery.
- A transmaxillary biopsy confirmed the diagnosis of neurofibroma.
- A combined basal subfrontal and subtemporal-infratemporal approach in two staged operations achieved total tumor resection.
Implications:
- Combined surgical approaches and staged operations are effective for resecting large, complex skull base neurofibromas.
- This case highlights the feasibility of radical resection for extensive tumors previously considered inoperable.
- Successful management requires a multidisciplinary approach and meticulous surgical planning.