Neurilemmoma of the pterygo-maxillary fossa

Trigeminal nerve tumors of the lateral skull base

A retrospective review of 8 trigeminal nerve tumors centered in the lateral skull base was carried out. Clinical manifestations, radiographic features, and outcome of management are detailed. Six patients in this series presented for primary surgery, and 2 patients had prior surgical interventions with incomplete resections.Surgical exposure via the infratemporal fossa (ITF) approaches resulted in complete tumor extirpation in all but I of the reoperated cases. Limited postoperative cranial neuropathies and the lack of intracranial complications are particularly notable in this series.A mean follow-up of 3 years revealed no evidence of recurrent disease. In the case of incomplete resection, there appears to be no appreciable growth of the small tumor remnant in the region of the cavernous sinus after 5 years.Trigeminal tumors of the lateral skull base with intracranial components below the level of the posterior clinoid process are ideally suited for the ITF techniques. The importance of securing the petrous carotid artery through a wide exposure is emphasized.

A gigantic neurilemoma originating in the pterygopalatine fossa. Case report

A 7-year-old girl complained of gradually progressing right nasal obstruction, right exophthalmos, and deterioration of right visual acuity. Computed tomography scanning showed a large mass originating in the pterygopalatine fossa and extending to both the pterygomaxillary fossa and the orbital apex on the right side. The tumor was totally removed via the orbitozygomatic infratemporal approach. The literature is reviewed and the operative approach is discussed.

Extra-cranial tumours of the infratemporal fossa

We have reviewed the world literature on infra-temporal fossa tumours and have presented a further 12 cases diagnosed by ourselves. The similarity in incidence of the 3 types of tumor (1) primary, (ii) contiguous and (iii) metastatic between our series and world experience has been observed. The anatomy of the intra-temporal fossa has been described in detail and the connection between the infra-temporal fossa and the parapharyngeal space is clarified. We also have emphasised the relationship between the deep lobe of the parotid gland and the infra-temporal fossa, and the improbability of deep lobe tumours spreading to the infra-temporal fossa, although superficial lobe tumours may do so by invasion through the mandibular notch. Attention has been direct to the frequent presentation of these tumours in the superior gingivo-buccal sulcus. Since facial pain is frequently a presenting symptom of these tumours many months before diagnosis, emphasis has been laid on the desirability of CAT scanning forming an integral part of the investigation, especially in patients complaining of undiagnosed facial pain.