経鼻内視鏡下経上顎洞アプローチで摘出した翼口蓋窩三叉神経鞘腫症例

A case of trigeminal schwannoma in the pterygopalatine fossa removed using an endoscopic endonasal approach

はじめに

　三叉神経鞘腫は，発生母地である三叉神経の走行するいずれの部位からも発生しうるが，翼口蓋窩や眼窩といった頭蓋外のみに限局するものは比較的稀で，その頻度は約5％とされている^1）。今回われわれは経鼻内視鏡下経上顎洞アプローチで摘出した翼口蓋窩三叉神経鞘腫の症例を経験したので，若干の文献的考察を加えて報告する。

　We report a case of trigeminal schwannoma with calcification in the pterygopalatine fossa. A 33-year-old man presented with headache. Imaging examinations revealed a tumor in the pterygopalatine fossa with calcification. The tumor was removed using an endoscopic endonasal approach. We diagnosed the tumor as schwannoma based on the pathological findings. There was rough calcification inside the tumor, suggesting a long-term course. After surgery, there was no neurologic dysfunction or recurrence. The endoscopic endonasal approach is a useful technique for excising trigeminal schwannomas in the pterygopalatine fossa, with the advantages of shorter hospitalization and fewer complications than those following traditional surgical approaches.