Abstract
Metastatic involvement of the trigeminal nerve is a rare manifestation of malignant neoplasms. Squamous cell carcinoma of the head and neck, lymphoma, and lung and colon cancers are reported to affect Meckel's cave. Little is known to why tumors may metastasize and involve some branches of the trigeminal nerve. In case of suspicious lesions, an endoscopic transnasal biopsy approach into the pterygopalatine and the infratemporal fossa is an option. An endoscopic transnasal transpterygoid approach to the Meckel's cave and middle cranial fossa is described in our case. Neurosurgical literature reports that open approaches to this area subject the brain parenchyma to stretch forces that render gaining full access somewhat challenging. The choice of approach should be tailored to the case and the size of the tumor and the prognosis of the patient. In our reported case, the biopsy was performed in the described technique without complications or a major cerebrospinal fluid leak.
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