title: Multimodality Management of Trigeminal Schwannomas.
abstract: Patients presenting with trigeminal schwannomas require multimodality management by a skull base surgical team that can offer expertise in both transcranial and transnasal approaches as well as radiosurgical and microsurgical strategies. Improvement in neurologic symptoms, preservation of cranial nerve function, and control of mass effect are the primary goals of management for trigeminal schwannomas. Complete surgical resection is the treatment of choice but may not be possible in all cases. Radiosurgery is an option as primary management for small- to moderate-sized tumors and can be used for postoperative residuals or recurrences. Planned surgical resection followed by SRS for residual tumor is an effective option for larger trigeminal schwannomas. The endoscopic resection is an excellent approach for patients with an extradural tumor or tumors isolated to the Meckel cave. A detailed analysis of a tumor and its surroundings based on high-quality imaging can help better estimate the expected outcome from each treatment. An expert skull base team should be able to provide precise counseling for each patient's situation for selecting the best option.
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, United States.
authors.forename: Ajay
authors.initials: A
authors.lastname: Niranjan
authors.affiliation: Department of Neurological Surgery, UT Southwestern Medical Center, Dallas, Texas, United States.
authors.forename: Samuel
authors.initials: S
authors.lastname: Barnett
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, New York, New York, United States.
authors.forename: Vijay
authors.initials: V
authors.lastname: Anand
authors.affiliation: Department of Neurosurgery, University of South Florida, Tampa, Florida, United States.
authors.forename: Siviero
authors.initials: S
authors.lastname: Agazzi
keywords: endoscopic resection; radiosurgery; skull base; transnasal approaches; trigeminal schwannomas