Introduction: Meningiomas and schwannomas represent a subset of primary intracranial tumors that are rarely identified exclusively in the paranasal sinuses. Here, we describe our experience with minimally invasive endoscopic endonasal approaches for the treatment of these tumors.

Methods: We retrospectively reviewed the clinical, surgical, and radiographic characteristics of adults with pathologically confirmed sinonasal meningiomas and schwannomas located within the paranasal sinuses that were resected via an expanded endoscopic endonasal approach.

Results: Five patients (1 male, 4 females) underwent an endoscopic endonasal approach for resection sinonasal tumor. Clinical symptomatology most commonly included nasal obstruction, in addition to headache, jaw pain, anosmia and chronic rhinosinusitis. Tumors were located exclusively within the sinonasal cavity and were, on average 2.2 cm (range 1.4-3.8 cm). Pathology revealed 2 cases of meningioma and 3 cases of schwannoma. No evidence of tumor recurrence occurred over average follow-up of 1.5 years (range 0.11-3.9 years).

Conclusions: Our case series suggests that an expanded endoscopic endonasal approach with a combined neurosurgical-otorhinolaryngologic team for the resection of sinonasal meningiomas and schwannomas offers an effective treatment option. Further studies that include a larger number of patients over a longer follow period are required to compare outcomes between minimally invasive and open approaches.

Patient Care: This research supports the central role of the neurosurgeon in the treatment of primary intracranial tumors that are located extracranially, within the paranasal sinuses.

Learning Objectives: By the conclusion of this session, participants should be able to: 1) Recognize the presence of primary intracranial tumors located in the paranasal sinus cavities 2) Discuss the use of endoscopic approaches for the treatment of tumors located in the paranasal sinuses 3) Appreciate the multidisciplinary approach to endoscopic sinus surgery for neurosurgical disease treatment.

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