title: [Surgical management of dumbbell-shaped trigeminal neurinomas].
abstract: OBJECTIVE
  To investigate the best surgical approach for the removal of dumbbell-shaped trigeminal neurinomas (DSTNs).
  
  
  METHODS
  The clinical materials of 46 patients with DSTNs surgically treated were analysed retrospectively. The patients were divided into two groups. In the early group (1978 - 1984), a series of conventional intradural approaches were used, and in the late group (1985 - 2000), an epidural approach via the skull-base craniotomy was used.
  
  
  RESULTS
  Total tumor removal was achieved in 42% (5/12) of the early group and 85% (29/34) of the late group (chi(2) = 8.8, P < 0.01). Temporary and permanent cranial nerve morbidities were 63% and 47% (chi(2) = 3.4, P > 0.05) in the early group and 48% and 15% in the late group (chi(2) = 6.1, P < 0.05).
  
  
  CONCLUSIONS
  The best microsurgical approach for the removal of DSTNs is epiduro-transduro-transtentorial approach via skull-base craniotomy. It is not necessary to resect the petrous apex.
authors.affiliation: Department of Neurosurgery, Huashan Hospital, Shanghai Fudan University, Shanghai 200032, China.
authors.forename: Liangfu
authors.initials: L
authors.lastname: Zhou
authors.forename: Ying
authors.initials: Y
authors.lastname: Mao
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000601:surgery*; D019635:Neurosurgical Procedures; D020433:Trigeminal Nerve Diseases / Q000601:surgery*