Nasal-subfrontal giant schwannoma.

ABSTRACT Subfrontal schwannomas are rare lesions. They can be misdiagnosed asolfactory meningiomas or neuroblastomas. We report a case of giantschwannoma involving the anterior cranial fossa; the frontal and ethmoidsinuses and nasal cavities. The patient presented with a year-long history ofincreasingly severe headache associated with insomnia. Examination revealedno neurological deficit except for the anosmia. Magnetic Resonance Imagingrevealed a 9x5x3 cm intranasal-subfrontal extraaxial mass. Nasal biopsyindicated the presence of a schwannoma. The lesion was totally removedthrough a bifrontal craniotomy and the skull base was repaired with periostealflap, fibrin glue and a split craniotomy graft. In addition to the cosmeticadvantages over standard transfacial approaches, the extended subfrontalapproach also provides early dissection of neural tissues, avoiding aninadvertent cerebrospinal fluid leak. KEY WORDS: Schwannoma, Anterior Cranial Fossa, Nasal Cavity, ParanasalSinuses, Surgery