title: Trigeminal schwannomas:  skull base approaches and operative results in 105 patients.
abstract: BACKGROUND
  Trigeminal schwannomas make up 0.8% to 8% of all intracranial schwannomas.
  
  
  OBJECTIVE
  To analyze our surgical experience with trigeminal schwannomas.
  
  
  METHODS
  We performed 107 operations on 105 patients harboring trigeminal schwannomas over the past 30 years. We classified the tumors as peripheral, ganglion cavernous, posterior fossa root, and dumbbell types according to the portion of the nerve that gave rise to the tumor.
  
  
  RESULTS
  Fourteen were peripheral-type tumors (13.1%), 39 (36.4%) were ganglion cavernous type, 22 (20.6%) were posterior fossa root type, and 32 (30.0%) were dumbbell type. Sixty-five tumors were solid, 35 were mixed, and only 7 were cystic. Among solid tumors, 14 were vascular, fibrous, and adherent to adjacent structures. Total or near-total removal was performed in 86 cases (81.9%), and subtotal removal was achieved in 18 (17.1%). The most common symptom was facial hypesthesia, occurring in 69 patients. This symptom improved in 11 patients, persisted in 50 patients, and worsened in 8 patients after surgery. New postoperative hypesthesia was observed in 8 patients. The second most common symptom was facial pain, observed in 24 patients. Facial pain subsided in 22 and persisted in 2 patients after surgery. Diplopia was observed in 21 patients. This symptom improved postoperatively in 14 patients, persisted in 6 patients, and worsened in 1 patient.
  
  
  CONCLUSIONS
  The present series demonstrates acceptable results using microsurgical treatment to remove trigeminal schwannomas. Pain and diplopia may be relieved after surgery; however, hypesthesia frequently remains or may be worsened by surgery.
authors.affiliation: Department of Neurosurgery, Sapporo Medical University School of Medicine, Hokkaido, Japan. wanibuti@sapmed.ac.jp
authors.forename: Masahiko
authors.initials: M
authors.lastname: Wanibuchi
authors.forename: Takanori
authors.initials: T
authors.lastname: Fukushima
authors.forename: Ali R
authors.initials: AR
authors.lastname: Zomordi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nonaka
authors.forename: Allan H
authors.initials: AH
authors.lastname: Friedman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003390:Cranial Nerve Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D003399:Craniotomy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D019291:Skull Base / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D020433:Trigeminal Nerve Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D055815:Young Adult