A Dumbbell-shaped hypoglossal schwannoma managed by a combination of open surgery and endoscopic assistance

Background: Hypoglossal schwannoma is a rare benign tumor that comprises about 5% of all intracranial schwannoma. Surgical management for hypoglossal schwannoma is still evolving along with our understanding of neuroanatomy and surgical equipment improvement, especially endoscopy. The far lateral transcondylar approach is commonly used for hypoglossal schwannomas. This traditional approach requires great effort and is considered a lengthy procedure. The use of endoscopy gives an additional advantage to microscopic surgery in managing this tumor, making surgery less complicated and faster. Combining the microscope and endoscope is an effective way to operate in small corridors. Case: In a stepwise fashion, we present a case of a 53-year-old female with hypoglossal schwannoma, which was successfully resected using a retrosigmoid transcondylar approach with endoscopic assistance. Conclusion: A retrosigmoid transcondylar approach with endoscopic assistance is an excellent option in surgical management for hypoglossal schwannoma. Both microscopic and endoscopic approaches will be gaining more usefulness in managing skull base tumors and should be used collaboratively.