Document Type : Original Article
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Abstract
Background: When a schwannoma affects the mandibular branch from the trigeminal nerve, the solid mass enlarges the foramen ovale, with components below, in the masticatory space, and above, in the middle cranial fossa. Atrophy of the masticator muscles is common. the pterygopalatine fossa and infratemporal fossa are adjacent and continuous spaces, masses that arise in one space can easily spread to the other. the tumors of the infratemporal fossa are uncommon and rarely, they may arise from within the infratemporal fossa itself. endoscopic access to this area often begins with surgical access to the pterygopalatine fossa, with more lateral dissection allowing entry to the infratemporal fossa. Schwannomas are very uncommon in children (except when associated with neurofibromatosis type 2. The advantages of the endoscopic technique are numerous, including Relatively straightforward access is achieved to the pterygopalatine fossa and infratemporal fossa, areas traditionally considered difficult to reach. Case Description: A.Q.K, an 8-year-old boy, presented with a three-month history of right eye painless protrusion, blurring of vision and a one-week history of swelling over the right cheek. On examination; There was a noticeable right-sided facial swelling with right eye protrusion, globe displacement Antero superiorly, A radiological examination showed large soft tissue mass involved Right pterygopalatine fossa & infratemporal fossa, Histopathological examination confirmed the diagnosis of schwannoma Complete excision was achieved using modified endoscopic danker’s approach. conclusion: Right. Maxillary sinus. The post-operative period was uneventful. The target for our case report is highlighting the rarity of this lesion (Infratemporal schwannoma of the mandibular branch of the trigeminal trunk in an 8years old boy), Emphasizing the significance of an accurate diagnosis and including this tumor in the differential diagnosis of facial asymmetry. The endoscopic technique provides a magnified and multiangled view for more precise discrimination of the dissection planes between the tumor and the adjacent structures. This technique obviates the need for external facial incisions or intra-oral incisions and helps in good surgical outcomes and quick healing and recovery.
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