Publication:

Endoscopic trans nasal excision of pterygopalatine fossa schwannoma: case report and review of literature

The pterygopalatine fossa is a difficult area for surgical access and lesions in this area traditionally advocated open external trans maxillary approaches. With endoscopic techniques, it is possible to not only access and explore this area but also plan complete excision of lesions in the pterygopalatine fossa. We present a case report of a 26-year-old lady with complaints of pain in the area of the left cheek for 6 months. She had no other co-morbidities. On clinical examination, no abnormality was detected.  Radiological examination with magnetic resonance imaging showed a lesion possibly a schwannoma in the left pterygopalatine fossa behind the left maxillary sinus. Complete excision was achieved using trans nasal endoscopic technique through the left maxillary sinus. Histopathological examination confirmed the diagnosis of schwannoma.  Post-operative period was uneventful and she was free from any pain and neurological symptoms on subsequent follow up. Schwannomas in the pterygopalatine fossa are rare entities. Endoscopic techniques are safe and effective in accessing the pterygopalatine fossa for excision of lesions situated in this area. This technique obviates the need for external facial incisions or intra oral incisions and helps in good surgical outcomes and quick healing and recovery.