title: Operative management of trigeminal neuromas: an analysis of a surgical experience with 55 cases.
abstract: BACKGROUND
  The trigeminal schwannoma is the second most common intracranial schwannoma. Their proximity to the critical skull base neural and vascular structures increases the complexity of surgical treatment. The aim of this study was to better understand the surgical approaches and the prognosis, as well as to assess the optimum therapeutic schedule.
  
  
  METHODS
  This was a retrospective study of 55 patients with trigeminal schwannomas who visited our department between Jan 2007 and Jan 2012. We analyzed the clinical and radiological presentation, tumor characteristics, surgical approaches, the prognosis.
  
  
  RESULTS
  The patients were 30 women and 25 men of mean age 36 years (range, 6-66 years) who received postoperative neurological and neuroradiological follow-up. The tumor was located in the middle fossa (type A) in 13 cases, in the posterior fossa (type B) in ten cases, in the middle and posterior fossae (type C) in 21 cases, and in the branches of the trigeminal nerve (type D) in 11 cases. The most common symptom was facial hypesthesia or numbness in 36 patients (65 %) . Total and nearly total tumor resection was achieved in 51 cases (93 %). Three patients (5 %) had worsening of preexisting deficits and there was no perioperative mortality. With an average follow-up period of 35 months, facial hypesthesia persisted in 26 patients (72 %),and improved in ten patients (28 %). Facial pain was relieved in 11 patients (100 %). There has been a recurrence in one case (2 %) and all patients resumed independent and social reintegration.
  
  
  CONCLUSIONS
  This study demonstrates radical surgery with excellent neurological outcomes is the primary treatment of trigeminal schwannomas. Appropriate selection of surgical approach according to tumor types is highly important and necessary. The preoperative facial pain could be relieved, hypesthesia frequently remains or could even be worsened after surgery.
authors.affiliation: Department of Neurosurgery, The Chinese PLA General Hospital, the No.28 Fuxing Road, Haidian District, Beijing, 100853, China.
authors.forename: Li-Feng
authors.initials: LF
authors.lastname: Chen
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.forename: Xin-Guang
authors.initials: XG
authors.lastname: Yu
authors.forename: Qiu-Ping
authors.initials: QP
authors.lastname: Gui
authors.forename: Bo
authors.initials: B
authors.lastname: Bu
authors.forename: Bai-Nan
authors.initials: BN
authors.lastname: Xu
authors.forename: Ding-Biao
authors.initials: DB
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003390:Cranial Nerve Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009442:Neurilemmoma / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods* / Q000592:standards; D012189:Retrospective Studies; D016896:Treatment Outcome; D020433:Trigeminal Nerve Diseases / Q000601:surgery*; D055815:Young Adult