Endonasal Endoscopic Hydatid Cyst Removal Located in the Pterygopalatine Fossa

Abstract

Introduction: Hydatid cyst (Echinococcosis) is a zoonosis, most commonly caused by the larval stage of Echinococcus granulosus. The disease has a worldwide geographic distribution and the Mediterranean region is an important endemic area. Definitive hosts are carnivores (e.g. dogs, foxes, cats), and humans are accidental hosts. The infection occurs by ingesting food contaminated with Echinoccocus eggs. Hydatid cysts are most commonly seen in the liver and lungs. Head and neck involvment is rare. To our knowledge, this is the sixth reported case of pterygopalatine fossa involvement in literature. Case report: A 45-years old female patient presented with a hydatid cyst in the right pterygopalatine fossa, which was accidentally discovered on MRI of the head performed for follow up due to previous hydatid cyst management in the parietooccipital brain lobe. We managed the cyst with endoscopic endonasal approach. Discussion: In this report, we present a case of hydatid cyst of the right pterygopalatine fossa and right middle nose meatus which was treated with endoscopic endonasal approach. Conclusion: The hydatid cyst of pterygopalatine fossa is extremely rare. A multidisciplinary approach is mandatory in the management of hydatid cysts. Endoscopic endonasal management has low morbidity and the technique may vary due to surgeon skills, localization of the cyst and available instruments

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