Surgical treatment of trigeminal schwannomas

Abstract

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.

Stereotactic Radiosurgery for Trigeminal Schwannoma: A Clinical Retrospective Study in 52 Cases

“…However, complete resections are not always possible with the main obstacle being removal of the cavernous portion of the tumor [9,10]. The tumor size is another important factor dictating resection rates with modern series reporting >95% total resection rates for small- to moderate-sized tumors (≤3 cm diameter).…”

Endoscope-Assisted Retrosigmoid Intradural Suprameatal Approach for Surgical Treatment of Trigeminal Schwannomas

“…2,10,15,24 It is thought to result from compression of cranial nerve VI in the cavernous sinus or the Dorello canal and usually responds well to decompression after surgery. 2,8-10 The 1 patient who presented with this symptom in this study improved significantly after the operation.…”

Surgery for a Case of Three-Compartment Trigeminal Schwannoma : Technical Aspects

“…Surgical strategies for three-compartment tumors need combination of various approaches, since there were limitations of bony structures dividing each compartment 1,[3][4][5]10,11) . The infratemporal fossa plate and zygomatic arch disturb access to infratemporal fossa in subtemporal approach.…”

“…Tumors involving three distinct compartments result in complicated clinical manifestations and radiological findings. Magnetic resonance imaging (MRI) and three-dimensional computed tomography (CT) has allowed the more clear elucidation of the pattern of extension 11,12) . They are also helpful to design surgical strategies to approach each compartments.…”