Transmandibular surgical approach in managing a giant trigeminal schwannoma: a rare case with postoperative complication

Abstract

Schwannoma is a benign tumor of the nerve sheath arising from the perineural schwann cells. Schwannomas can occur along the pathway of any somatic or sympathetic nerve. The nerves most commonly involved in schwannomas of the head and neck are the vagus and the cervical sympathetic chain. Trigeminal schwannomas are infrequent, benign tumors originating from Schwann cells. These tumors, particularly when large, mostly have late presentations and pose significant surgical challenges due to proximity to vital cranial structures. We present a rare clinical case of a 33year old female patient with a chief complaint of swelling on face, diagnosed as suffering from benign tumor extending from cranial base (from foramen ovale) to the parapharyngeal space. Mandibular access osteotomy was done to expose the tumor. Surgical excision of the tumor was done along with the preservation of the nerve. The patient experienced notable complications in the postoperative period, requiring multidisciplinary intervention. This report highlights the surgical planning, challenges in operative technique, and complexities of the postoperative care.