BACKGROUND: Extracranial schwannomas can readily occur in the head and neck region and rarely involve the trigeminal nerve. As a rule, their treatment is surgical and dictated by the location of the tumor and nerve of origin. METHODS: We describe a case of a 14-year-old boy with a mass invading right nasal fossa, maxillary sinus, orbital floor, pterygopalatine fossa, and infratemporal fossa. The diagnosis of a nerve sheath tumor was evoked after angiography showed no vascular blush. RESULTS: The tumor was removed through a Weber-Fergusson incision with subciliary extension followed by maxillozygomatic osteotomy. This approach showed the tumor to be coming from the infraorbital nerve and allowed complete tumor exposure and removal. Pathology confirmed the diagnosis of a schwannoma. CONCLUSION: We describe the osteoplastic maxillotomy approach which we felt most appropriate for removal of the infraorbital schwannoma and discuss other possible surgical options for this type of tumor. (c) 2007 Wiley Periodicals, Inc. Head Neck 2008.
BACKGROUND: Extracranial schwannomas can readily occur in the head and neck region and rarely involve the trigeminal nerve. As a rule, their treatment is surgical and dictated by the location of the tumor and nerve of origin. METHODS: We describe a case of a 14-year-old boy with a mass invading right nasal fossa, maxillary sinus, orbital floor, pterygopalatine fossa, and infratemporal fossa. The diagnosis of a nerve sheath tumor was evoked after angiography showed no vascular blush. RESULTS: The tumor was removed through a Weber-Fergusson incision with subciliary extension followed by maxillozygomatic osteotomy. This approach showed the tumor to be coming from the infraorbital nerve and allowed complete tumor exposure and removal. Pathology confirmed the diagnosis of a schwannoma. CONCLUSION: We describe the osteoplastic maxillotomy approach which we felt most appropriate for removal of the infraorbital schwannoma and discuss other possible surgical options for this type of tumor. (c) 2007 Wiley Periodicals, Inc. Head Neck 2008.