Vidian nerve neurofibroma removed via a transpterygoid approach

Minim Invasive Neurosurg. 2011 Oct;54(5-6):250-2. doi: 10.1055/s-0031-1283126. Epub 2012 Jan 25.


Background: Lesions originating in the vidian canal are extremely rare. Most frequently, they are extensions from contiguous carcinomas. We present a rare case of a vidian nerve neurofibroma and discuss its surgical management.

Case report: A 62-year-old woman with a history of a basal cell skin cancer was evaluated for bilateral tinnitus. Imaging revealed a left-sided lesion at the medial aspect of the pterygoid process base, over the vidian canal. Under image-guidance, an endonasal endoscopic transpterygoid approach was performed. The histopathological examination supported the diagnosis of neurofibroma.

Conclusion: Benign nerve sheath tumors of the vidian nerve should be considered in the differential diagnosis of a vidian canal lesion. Given the propensity of more aggressive tumors, a tissue diagnosis should be warranted in order to coordinate appropriate subsequent treatment. The expanded endonasal transpterygoid approach offers a safe, less invasive, and effective route to perform the excisional biopsy of such a lesion.

Publication types

  • Case Reports

MeSH terms

  • Cranial Nerve Neoplasms / diagnostic imaging
  • Cranial Nerve Neoplasms / pathology
  • Cranial Nerve Neoplasms / surgery*
  • Diagnosis, Differential
  • Endoscopy / methods*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Neurofibroma / diagnostic imaging
  • Neurofibroma / pathology
  • Neurofibroma / surgery*
  • Neurosurgical Procedures / methods*
  • Pterygopalatine Fossa
  • Tomography, X-Ray Computed
  • Treatment Outcome