Frilling MJ, Baugh RF and Jenkins OH
Extracranial meningiomas of the sphenoid sinus are extremely rare. They present a unique challenge to otolaryngologists and neurosurgeons regarding diagnosis and treatment when contiguous intracranial involvement is present. We present a case of a secondary sphenoid sinus meningioma extending from the temporal fossa and medial sphenoid ridge. Otolaryngologic endoscopic transnasal techniques are able to characterize masses of the nose and paranasal sinuses when intra and extracranial involvement is seen on imaging to further direct treatment with a lower associated morbidity than a craniotomy approach. Surgical excision of a secondary sphenoid sinus meningioma can be complicated due to frequent involvement of nearby neurovascular structures. Often, an endoscopic transnasal technique combined with a transfacial/transcranial approach is both required to achieve adequate resection of the meningioma, although complete resection is difficult.
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