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Wang Z, Zhang S, Qi Y, Cao L, Li P, Zhang Q. Excision of Greater Superficial Petrosal Nerve Schwannoma Via a Pure Endoscopic Endonasal Approach. EAR, NOSE & THROAT JOURNAL 2024; 103:13-18. [PMID: 34281408 DOI: 10.1177/01455613211026397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Greater superficial petrosal nerve (GSPN) schwannomas are an exceedingly rare nerve sheath tumor. The current literature search was conducted using Medline and Embase database by key search terms. Only 31 cases have been reported in the literature so far. Facial palsy, hearing loss, and xerophthalmia accounted for 48.4% (15), 41.9% (13), and 29% (9) of all cases, respectively. The middle cranial fossa approach was used in all previous reports. A retrospective review of 2 GSPN schwannomas patients treated by endoscopic endonasal approach (EEA) in our center was collected. Clinical records, including clinical features, pre- and postoperative images, surgery, and follow-up information, were reviewed. In all cases, clinical features including facial numbness and headache were found, with tinnitus in case 1, hearing loss, xerophthalmia in case 2. Imaging studies showed a solid mass that originated in the anterior of the petrous bone. Two patients were treated by EEA. Furthermore, no recurrence was found during the follow-up period (15-29 months) in both of the 2 cases after the operation. Complete resection of GSPN schwannomas can be achieved via the pure EEA. Endoscopic endonasal approach for radical removal of tumors is safe and feasible.
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Affiliation(s)
- Zhenlin Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Siyuan Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yan Qi
- Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lianjie Cao
- Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Pu Li
- Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qiuhang Zhang
- Department of Neurosurgery, Skull Base Surgery Center, Xuanwu Hospital, Capital Medical University, Beijing, China
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Sarwar M, Tripathy L, Pramanick G, Chatterjee S. The Greater Superficial Petrosal Nerve Schwannoma: A Brief Report. INDIAN JOURNAL OF NEUROSURGERY 2023. [DOI: 10.1055/s-0042-1759490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
AbstractSchwannoma of greater superficial petrosal nerve (GSPNS) is a rare tumor of middle cranial fossa. We report a case of GSPNS presenting with twitching of face and eyelid. We describe its characteristic radiological appearance. Total excision of the GSPNS was done through a subtemporal approach with complete relief of symptoms. GSPNS is a rare tumor of middle cranial fossa. Preoperative diagnosis may be misleading. A high index of suspicion is important to make a correct diagnosis and choose an appropriate approach for surgery as it is amenable to complete excision.
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Affiliation(s)
- Mohammad Sarwar
- Medica Institute of Neurological Diseases, Medica Superspecialty Hospital, Kolkata, West Bengal, India
| | - Laxminarayan Tripathy
- Medica Institute of Neurological Diseases, Medica Superspecialty Hospital, Kolkata, West Bengal, India
| | - Gobinda Pramanick
- Department of Radio-diagnosis, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
| | - Sanhita Chatterjee
- Department of Pathology, Medica Superspecialty Hospital, Kolkata, West Bengal, India
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Aftahy AK, Groll M, Wagner A, Barz M, Bernhardt D, Combs SE, Meyer B, Gempt J, Negwer C. Schwannomas of the greater superficial petrosal nerve - case series, discussion of surgical techniques, and review of literature. BMC Neurol 2022; 22:470. [PMID: 36494617 PMCID: PMC9733176 DOI: 10.1186/s12883-022-02960-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 10/28/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Facial nerve schwannomas account for about 0.8% of all petrous mass lesions. Schwannomas of the greater superficial petrosal nerve (GSPN) are a rare subtype with few case-reports up to date. CASE PRESENTATIONS A retrospective analysis of clinical outcomes, radiographic findings and postoperative complication between June 2007 and December 2020 was performed. Four cases of GSPN schwannomas were reported. The presenting symptoms were facial nerve palsy and hearing loss. Imaging studies showed a subtemporal mass on the anterosuperior aspect of the petrous bone, in one case with extraordinary petrous bone and mastoid infiltration and destruction. Three cases were removed through a subtemporal extra- or intradural approach, one case via a combined pre- and retrosigmoid approach. Improvement of facial nerve palsy occurred in one case; new hearing loss was observed in another case. Xeropthalmia was a short-term temporary deficit in three cases. Short- to mid-term follow-up of the patients has not shown any tumor recurrence. CONCLUSIONS GSPN schwannomas are rare entities presenting with heterogenous symptoms. Our surgical findings emphasize safe resection. Complete remission is possible by GTR. Since the small data set limits the expressiveness of statements regarding standard of care and alternative therapy options, additional data is needed.
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Affiliation(s)
- A. Kaywan Aftahy
- grid.6936.a0000000123222966School of Medicine, Klinikum Rechts Der Isar, Department of Neurosurgery, Technical University Munich, Munich, Germany
| | - Maximilian Groll
- grid.6936.a0000000123222966School of Medicine, Klinikum Rechts Der Isar, Department of Neurosurgery, Technical University Munich, Munich, Germany
| | - Arthur Wagner
- grid.6936.a0000000123222966School of Medicine, Klinikum Rechts Der Isar, Department of Neurosurgery, Technical University Munich, Munich, Germany
| | - Melanie Barz
- grid.6936.a0000000123222966School of Medicine, Klinikum Rechts Der Isar, Department of Neurosurgery, Technical University Munich, Munich, Germany
| | - Denise Bernhardt
- grid.6936.a0000000123222966School of Medicine, Klinikum Rechts Der Isar, Department of Radio-Oncology, Technical University Munich, Munich, Germany
| | - Stephanie E. Combs
- grid.6936.a0000000123222966School of Medicine, Klinikum Rechts Der Isar, Department of Radio-Oncology, Technical University Munich, Munich, Germany
| | - Bernhard Meyer
- grid.6936.a0000000123222966School of Medicine, Klinikum Rechts Der Isar, Department of Neurosurgery, Technical University Munich, Munich, Germany
| | - Jens Gempt
- grid.6936.a0000000123222966School of Medicine, Klinikum Rechts Der Isar, Department of Neurosurgery, Technical University Munich, Munich, Germany
| | - Chiara Negwer
- grid.6936.a0000000123222966School of Medicine, Klinikum Rechts Der Isar, Department of Neurosurgery, Technical University Munich, Munich, Germany
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Uppar AM, Rao S, Prasad C, Arimappamagan A, Santosh V. Schwannoma of the Greater Superficial Petrosal Nerve: An Unusual Site for a Common Tumor. J Neurol Surg A Cent Eur Neurosurg 2020; 81:565-570. [PMID: 32361981 DOI: 10.1055/s-0039-1685168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Greater superficial petrosal nerve (GSPN) schwannoma is a rare clinical entity. It forms a small subset of the larger group of facial nerve schwannomas. A thorough literature search yielded only 27 such cases reported to date in the English literature. We present one such rare case of GSPN schwannoma and discuss the clinical spectrum and management along with a review of the literature. We demonstrate the surgical steps in an operative video.
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Affiliation(s)
- Alok Mohan Uppar
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Shilpa Rao
- Department of Neuropathology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Chandrajit Prasad
- NIIR, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Arivazhagan Arimappamagan
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Vani Santosh
- Department of Neuropathology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
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Ishikawa T, Matsuda M, Sakakura K, Ishikawa E, Akutsu H, Matsumura A. Huge Greater Superficial Petrosal Nerve Schwannoma with Intradural Peritumoral Cyst. World Neurosurg 2019; 122:85-89. [DOI: 10.1016/j.wneu.2018.10.129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 10/21/2018] [Indexed: 11/29/2022]
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Takase H, Araki K, Seki S, Takase K, Murata H, Kawahara N. Unique Diagnostic Features and Surgical Strategy for Intracranial Carotid Sympathetic Plexus Schwannoma: Case Report and Literature Review. World Neurosurg 2017; 98:876.e1-876.e8. [DOI: 10.1016/j.wneu.2016.11.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 11/18/2016] [Accepted: 11/19/2016] [Indexed: 10/20/2022]
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Kusumi M, Oka H, Aliabadi H, Sato S, Kumabe T. The Appropriate Surgical Approach to a Greater Petrosal Nerve Schwannoma in the Setting of Temporal Lobe Edema. World Neurosurg 2016; 85:364.e5-10. [DOI: 10.1016/j.wneu.2015.08.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 08/12/2015] [Indexed: 11/24/2022]
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De Paulis D, Di Cola F, Marzi S, Ricci A, Coletti G, Galzio RJ. A rare case of greater petrosal nerve schwannoma. Surg Neurol Int 2011; 2:60. [PMID: 21697967 PMCID: PMC3114313 DOI: 10.4103/2152-7806.80352] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2011] [Accepted: 04/09/2011] [Indexed: 11/06/2022] Open
Abstract
Background: Facial nerve schwannomas include only 0.8% of all intrapetrous mass lesions, and schwannomas originating exclusively from the greater petrosal nerve (GPN) are extremely rare. To date, only 13 reports have been described. In this case, the tumor was thought to originate from the GPN on the basis of clinical, radiological, and operative findings. Case Description: A 23-year-old girl presented an acute left facial palsy, a disturbance in tear secretion of the ipsilateral eye, and a left-sided conductive hypoacusia. Computed tomography (CT) scan and magnetic resonance imaging (MRI) showed an extradural mass in the left middle fossa. A subtemporal approach was performed and the lesion, originating from the proximal portion of the GPN, was excised. The post-operative course was satisfactory, except for a xerophtalmia, which was treated with artificial teardrops. Conclusion: GPN schwannomas can originate anywhere alongside the course of the nerve, from its proximal segment near the facial hiatus to its distal segment near the foramen lacerum. For these reasons, it requires differential diagnosis with trigeminal nerve schwannomas or with injuries arising from the geniculate ganglion, because it can be easily confused with those lesions. However, in less severe cases, an early diagnosis can be able to preserve the function of the facial nerve by reducing iatrogenic injuries caused by surgical maneuvers.
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Affiliation(s)
- Danilo De Paulis
- Department of Neurosurgery, Second University of Naples, viale Colli Aminei 21, Naples, Italy
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Amirjamshidi A, Hashemi SMR, Abbassioun K. Schwannoma of the greater superficial petrosal nerve. J Neurosurg 2010; 113:1093-8. [DOI: 10.3171/2009.9.jns09439] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors report the clinical features, imaging and surgical findings, and follow-up of 5 rare cases of schwannoma of the middle fossa with possible origin from the greater superficial petrosal nerve (GSPN). All patients presented to a single neurosurgical institution. The study design was a prospective follow-up of 5 cases of schwannomas of the middle fossa that most likely originated from the GSPN. The presenting features were burning pain in the eyes in 2 cases, epilepsy and behavioral changes in 2 cases, and headache in 1 case. Imaging studies showed a subtemporal mass on the anterosuperior aspect of the petrous bone in all cases. An enhancing tail on the MR images was highly suggestive of the origin of the tumor from the GSPN. All tumors were removed through a subtemporal extra- or intradural approach.
Partial to complete peripheral facial nerve palsy was encountered after surgery in 3 cases, which recovered completely. Dry eye was the long-term permanent deficit in all cases. Mid- to long-term follow-up of the cases has not revealed any tumor recurrence. The 5 cases of schwannoma of the middle fossa with possible origin from GSPN were managed successfully, and their clinical presentation, differential diagnosis, and management are discussed.
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Affiliation(s)
- Abbas Amirjamshidi
- 1Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences; and
| | | | - Kazem Abbassioun
- 1Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences; and
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Ichimura S, Yoshida K, Sutiono AB, Horiguchi T, Sasaki H, Kawase T. Greater petrosal nerve schwannomas—analysis of four cases and review of the literature. Neurosurg Rev 2010; 33:477-82. [DOI: 10.1007/s10143-010-0277-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Revised: 05/11/2010] [Accepted: 05/27/2010] [Indexed: 11/28/2022]
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