Endoscopic endonasal surgery for pterygopalatine fossa schwannoma via prelacrimal recess-maxillary sinus.

OBJECTIVE: To explore a new approach for treating pterygopalatine fossa (PPF) schwannomas via endoscopic transnasal prelacrimal recess-maxillary sinus (MS). METHODOLOGY: Five patients with PPF schwannomas underwent surgical resection of the tumors using this approach. RESULTS: All patients had adequate exposure and complete tumor resection. No major postoperative complications were observed. No evidence of tumor recurrence was noted after follow-up with magnetic resonance imaging and serial evaluations for 12 to 40 months postoperatively. No patients had epiphora, and the shape of the inferior turbinate (IT) was favorable. CONCLUSIONS: Treatment of PPF schwannoma via endoscopic transnasal prelacrimal recess-MS is safe and effective. Additionally, this approach is minimally invasive not only for the PPF, from which the benign lesions can be completely removed, but also for the MS. This is especially true with lesions of the prelacrimal and alveolar recesses that can be resected. This approach is necessary to prevent structural and functional damage of the nasal cavity, especially the IT and nasolacrimal duct, allowing better healing with decreased morbidity and shorter recovery periods.