Sphenocavernous and Infratemporal Trigeminal Neurinomas: Surgical Series of 15 Cases

Visot, A; Derome, P; Leon, Juan Luis Maestro De

doi:10.1055/s-2008-1057125

Cited by 15 publications

(5 citation statements)

References 17 publications

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“…When trigeminal neurinomas extend through the porus trigeminus into the posterior fossa, remain cephalad to the seventh-eighth nerve complex, and lie lateral to the brainstem, they can be partially removed through the subtemporal (subtemporal-transtentorial) approach by incising the tentorium. 4,7,11,29 Resecting the apical pyramidal bone as described by Kawase's 14,15 anterior petrosal approach facilitates tumor extirpation by better exposing the tumor and the petroclinoid region down to the inferior petrosal sinus. The subtemporal extradural-intradural approach combined with an anterior petrosectomy can access the anterior surface of the ipsilateral pons, the origin of seventh-eighth nerve complex, the sixth cranial nerve, 1.5 cm of the basilar artery inferior to the trigeminal root, and the origin of the anterior inferior cerebellar artery while minimizing brain retraction.…”

Section: Surgical Approaches To Trigeminal Neurinomasmentioning

confidence: 99%

Comparison of conventional and skull base surgical approaches for the excision of trigeminal neurinomas

Jm²,

Hr³

et al. 1995

Journal of Neurosurgery

110

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Trigeminal neurinomas have traditionally been excised through conventional approaches. Because symptomatic tumor recurrence exceeds 50% after conventional procedures, the authors evaluated the use of skull base approaches to achieve complete resection and a lower rate of symptomatic recurrence. Comparisons of skull base with conventional approaches to trigeminal neurinomas have been limited to small series with short-term follow-up periods. The authors reviewed their experiences with conventional (frontotemporal transsylvian, subtemporal-intradural, subtemporal-transtentorial, and suboccipital) and skull base (frontotemporal extradural-intradural, frontoorbitozygomatic, subtemporal anterior petrosal, and presigmoid posterior petrosal) surgical approaches for the excision of trigeminal neurinomas. In this paper they report the results of 15 patients with trigeminal neurinoma who underwent 27 surgical procedures between 1980 and 1990. Seventeen of the procedures used conventional and 10 used skull base approaches. All patients had tumors arising from Meckel's cave and the porus trigeminus either initially or on recurrence. Tumors located in the cavernous sinus recurred most frequently (83%); other tumors that recurred frequently were those located in Meckel's cave and the porus trigeminus (67%), and the posterior fossa (17%). The tumor extended into the anterolateral wall of the cavernous sinus in 38% of patients with cavernous sinus involvement. Tumor exposure and ease of dissection were superior with skull base approaches. Residual or recurrent tumors were found in 65% of patients following conventional approaches compared with 10% of patients following skull base approaches. Using skull base approaches, the surgeon was more accurate (90%) in estimating tumor excision than when using conventional approaches (43%). Perioperative complications were similar with both. The authors discuss the indications, advantages, and limitations of each approach. Based on anatomical considerations, they propose a strategy to best resect these tumors.

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Section: Surgical Approaches To Trigeminal Neurinomasmentioning

confidence: 99%

Comparison of conventional and skull base surgical approaches for the excision of trigeminal neurinomas

Jm²,

Hr³

et al. 1995

Journal of Neurosurgery

110

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“…Neuromas arising from the distal branches of the trigeminal nerve with extension to the extracranial compartments are unusual and only 30 cases have been recognized in the literature [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. All of the tumors are histologically benign and slowgrowing, indicating that the diagnosis usually occurs late as it was in our case.…”

Section: Discussionmentioning

confidence: 78%

“…The trigeminal nerve root, the gasserian ganglion, and one of the three divisions may be the origin of such lesions, indicating that TNs may grow into distinct compartments including the cerebellopontine angle, cavernous sinus/Meckel's cave, and extracranial spaces (orbit, infratemporal fossa, and pterygopalatine fossa). Neuromas arising from the distal branches of the trigeminal nerve with extracranial extension (Jefferson's type D tumors) are extremely rare, with 30 cases having been recognized in the English literature since 1955 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Table 1 summarizes the literature describing cases with TNs involving infratemporal fossa.…”

Section: Introductionmentioning

confidence: 99%

Trigeminal Neuroma with Extracranial Extension: The 31st Case

Kafadar

Tanrıverdi²,

Canbaz³

et al. 2006

Minim Invasive Neurosurg

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“…2,3 With the evolution of microsurgery and skull base approaches, the rate of total removal has increased to 90% without serious complications. 1,6,8,11,[13][14][15][16][17] However, no single approach is suitable for every patient who presents with a trigeminal neurinoma. The authors used the COZ approach with a craniotomy designed to be more suitable for patients showing characteristic growth patterns on preoperative MR imaging.…”

Section: Discussionmentioning

confidence: 99%

A Cranio-Orbital-Zygomatic Approach to Dumbbell-Shaped Trigeminal Neurinomas Using the Petrous Window

et al. 2001

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We applied a cranio-orbital-zygomatic approach that extends the temporal craniotomy more posteriorly and minimizes the frontal orbitotomy of an ordinary orbitozygomatic approach in order to provide wide access to the already eroded petrous apices along the long axis of trigeminal neurinomas. We treated seven dumbbell-shaped trigeminal neurinomas between 1991 and 1998 (mean follow-up, 38 months; range, 9 to 109 months). The configuration of the tumor mass was assessed on magnetic resonance imaging by measuring its long diameter in the middle and posterior fossae and the width of petrous erosion. Tumors were then classified into five types based on their distribution over the petrous ridge. Total removal was achieved in six patients, who showed no evidence of tumor recurrence during the follow-up period. The only major complication was one case of anesthesia dolorosa. The one patient with a subtotal removal developed a recurrence 12 months after surgery, in the posterior fossa. The cranioorbital-zygomatic approach could be an effective method for removing dumbbellshaped trigeminal neurinomas, particularly in cases ofwide petrous erosion from the tumor. If, however, the tumor has a larger posterior fossa component, this approach may not provide adequate exposure to achieve a total resection.

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Sphenocavernous and Infratemporal Trigeminal Neurinomas: Surgical Series of 15 Cases

Cited by 15 publications

References 17 publications

Comparison of conventional and skull base surgical approaches for the excision of trigeminal neurinomas

Comparison of conventional and skull base surgical approaches for the excision of trigeminal neurinomas

Trigeminal Neuroma with Extracranial Extension: The 31st Case

A Cranio-Orbital-Zygomatic Approach to Dumbbell-Shaped Trigeminal Neurinomas Using the Petrous Window

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