Endoscopic resection of retromaxillary schwannomas

• Published in: Operative techniques in otolaryngology--head and neck surgery 2014, Vol.25 (3), p.274-283
• Main Authors: Sreenath, Satyan B., BS, McKinney, Kibwei A., MD, McClurg, Stanley W., MD, Recinos, Pablo F., MD, Sasaki-Adams, Deanna M., MD, Ewend, Matthew G., MD, Zanation, Adam M., MD
• Format: Article
• Language: English
• Subjects: Endoscopic management; Otolaryngology; Retromaxillary space; Schwannoma; Skull base tumor; Surgery
• ISSN: 1043-1810; 1557-9395
• DOI: 10.1016/j.otot.2014.04.009

The purpose of this article is to provide a detailed explanation of the anatomical and technical considerations of the endoscopic endonasal approach for the resection of schwannomas located in the retromaxillary space. This approach often requires the establishment of a transmaxillary, transpterygoid corridor to reach the full extent of the retromaxillary space. As schwannomas are often encapsulated, well circumscribed, and peripherally attached to the parent nerve, complete resection is an achievable surgical goal. Although technically challenging, this minimally invasive approach to retromaxillary lesions minimizes facial incisions, displacement of normal tissue, and operative morbidity. Potential complications of the endoscopic approach include synechiae formation, trismus, vascular or nerve injury, and cerebrospinal fluid leak. With a thorough knowledge of the operative technique and anatomical boundaries, the endoscopic endonasal approach is a highly valuable surgical modality for the resection of retromaxillary schwannomas.