Endoscopic transpterygoid approach for resection of trigeminal neurotropic melanoma: Case report and technical note

Abstract

Background The endoscopic transpterygoid approach to Meckel's cave is an established technique for resection of trigeminal schwannomas. Modern endoscopes provide excellent intraoperative visualization of anatomic structures and relevant pathology while the minimally-invasive nature of the procedure allows for rapid postoperative recovery. Neurotropic melanoma is a rare clinical entity that often involves the head and neck and can lead to cranial neuropathies when nerve invasion occurs. Pathological diagnosis of this lesion can be challenging due to its rarity and lack of classic melanoma markers such as Melan-A and HMB-45. Case description In this article, the authors describe the endoscopic transpterygoid approach to a neurotropic melanoma involving the maxillary and infraorbital nerves. To our knowledge, this is the first use of this surgical approach for resection of neurotropic melanoma. Conclusions Endoscopic approaches to the trigeminal nerve allow for safe and effective resection of these lesions. However, a strong understanding of the microsurgical anatomy is necessary prior to such an undertaking.