Surgical treatment of trigeminal schwannomas.
Schwannomas that arise from the trigeminal nerve are rare, but this nerve is the second most frequent intracranial site of schwannoma occurrence next to the vestibular nerve. The advent of microsurgical techniques and skull-base approaches has greatly enhanced the surgical management of these tumors, and outcomes have improved markedly. This report documents 18 cases of histologically verified schwannomas that arose from the trigeminal nerve and were treated surgically in our clinic between January 1992 and July 2005. The patients were ten women and eight men of age 39.7 years (range, 22-62 years). The tumor was located in the middle fossa (type A) in five cases, in the middle and posterior fossae (type C) in nine cases, in the posterior fossa (type B) in two cases, and in the branches of the trigeminal nerve (type D) in two cases. Total excision was achieved in 17 cases, and there was no mortality in the series. Our results indicate that trigeminal schwannomas, regardless of type, can be removed via skull-base approaches. We present an algorithm for surgical management of trigeminal schwannomas based on our experience and information from the literature.
Department of Neurosurgery, Marmara University, Neurological Sciences Institute, Acibadem Kozyatagi Hospital, Istanbul, Turkey.
M Necmettin
MN
Pamir
Selçuk
S
Peker
Fatih
F
Bayrakli
Türker
T
Kiliç
M Memet
MM
Ozek
D000328:Adult; D015331:Cohort Studies; D003390:Cranial Nerve Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019291:Skull Base; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020433:Trigeminal Nerve Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*