Trigeminal Schwannoma – Case Report of a Rare Tumour

Dabas, Surendra K; Menon, Nandini N; Ranjan, Reetesh; Gurung, Bikas; Tiwari, Sukirti; Shukla, Himanshu; Sharma, Ashwani; Sinha, Ajit; Singh, J. B.; Singal, Rishu

doi:10.1007/s12070-022-03405-6

Cited by 3 publications

(2 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Trigeminal schwannomas can present in three different anatomical situations [19,[21][22][23]. (1) Schwannomas that involve the trigeminal branches and extend to the pterygopalatine or infratemporal fossae.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Anatomical Comparison of Surgical Approaches to Meckel’s Cave

Zanin,

Agosti,

Ebner

et al. 2023

JCM

View full text Add to dashboard Cite

Background: Meckel’s cave is a challenging surgical target due to its deep location and proximity to vital neurovascular structures. Surgeons have developed various microsurgical transcranial approaches (MTAs) to access it, but there is no consensus on the best method. Newer endoscopic approaches have also emerged. This study seeks to quantitatively compare these surgical approaches to Meckel’s cave, offering insights into surgical volumes and exposure areas. Methods: Fifteen surgical approaches were performed bilaterally in six specimens, including the pterional approach (PTA), fronto-temporal-orbito-zygomatic approach (FTOZA), subtemporal approach (STA), Kawase approach (KWA), retrosigmoid approach (RSA), retrosigmoid approach with suprameatal extension (RSAS), endoscopic endonasal transpterygoid approach (EETPA), inferolateral transorbital approach (ILTEA) and superior eyelid approach (SEYA). All the MTAs were performed both with 10 mm and 15 mm of brain retraction, to consider different percentages of surface exposure. A dedicated navigation system was used to quantify the surgical working volumes and exposure of different areas of Meckel’s cave (ApproachViewer, part of GTx-Eyes II, University Health Network, Toronto, Canada). Microsurgical transcranial approaches were quantified with two different degrees of brain retraction (10 mm and 15 mm). Statistical analysis was performed using a mixed linear model with bootstrap resampling. Results: The RSAS with 15 mm of retraction offered the maximum exposure of the trigeminal stem (TS). If compared to the KWA, the RSA exposed more of the TS (69% vs. 46%; p = 0.01). The EETPA and ILTEA exposed the Gasserian ganglion (GG) mainly in the anteromedial portion, but with a significant 20% gain in exposure provided by the EETPA compared to ILTEA (42% vs. 22%; p = 0.06). The STA with 15 mm of retraction offered the maximum exposure of the GG, with a significant gain in exposure compared to the STA with 10 mm of retraction (50% vs. 35%; p = 0.03). The medial part of the three trigeminal branches was mainly exposed by the EETPA, particularly for the ophthalmic (66%) and maxillary (83%) nerves. The EETPA offered the maximum exposure of the medial part of the mandibular nerve, with a significant gain in exposure compared to the ILTEA (42% vs. 11%; p = 0.01) and the SEY (42% vs. 2%; p = 0.01). The FTOZA offered the maximum exposure of the lateral part of the ophthalmic nerve, with a significant gain of 67% (p = 0.03) and 48% (p = 0.04) in exposure compared to the PTA and STA, respectively. The STA with 15 mm of retraction offered the maximum exposure of the lateral part of the maxillary nerve, with a significant gain in exposure compared to the STA with 10 mm of retraction (58% vs. 45%; p = 0.04). The STA with 15 mm of retraction provided a significant exposure gain of 23% for the lateral part of the mandibular nerve compared to FTOZA with 15 mm of retraction (p = 0.03). Conclusions: The endoscopic approaches, through the endonasal and transorbital routes, can provide adequate exposure of Meckel’s cave, especially for its more medial portions, bypassing the impediment of major neurovascular structures and significant brain retraction. As far as the most lateral portion of Meckel’s cave, MTA approaches still seem to be the gold standard in obtaining optimal exposure and adequate surgical volumes.

show abstract

Section: Discussionmentioning

confidence: 99%

Quantitative Anatomical Comparison of Surgical Approaches to Meckel’s Cave

Zanin,

Agosti,

Ebner

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…TS are rare compared to vestibular schwannomas [31] . Trigeminal schwannomas can originate from any section of the fifth cranial nerve, from the root to the distal extracranial branches, but most develop from the gasserian ganglion, which usually grows in the middle skull [32] . There are different symptoms that patients with this tumour usually present.…”

Section: Schwannomasmentioning

confidence: 99%

Trigeminal surgery: A review

Tavares¹,

Cepeda²,

Gómez³

et al. 2023

Int. J. Appl. Dent. Sci.

View full text Add to dashboard Cite

Introduction:The study of trigeminal surgery is linked to trigeminal neuralgia and being a serious disorder can impair the patient's quality of life. Objective: To analyze the literature on relevant aspects of trigeminal surgery, such as decompression, sensitivity, anesthesia and schwannomas. Methodology: PubMed, SCOPUS and Google Scholar databases were reviewed to find recent articles published on trigeminal surgery with the following keywords: "trigeminal nerve", "trigeminal surgery", "decompression", "schwannomas", "anesthesia". Results: Microvascular decompression is the most effective procedure for the management of trigeminal neuralgia; highly favourable results have been achieved with this technique. Sensitivity is of great importance in the treatment of this condition, since it is the reason why patients will come for consultation with the aim of eliminating any discomfort related to a nerve condition. Anesthesia requires correct management for a good result in trigeminal surgery and to provide the best care and recovery to patients. Schwannomas are usually benign and rare intracranial tumours. There are several treatments that can help to treat them, the most used and that has achieved excellent results is gamma knife radiosurgery. Conclusions: Trigeminal neuralgia is a condition that usually appears in one or more branches of the trigeminal nerve, trigeminal surgery is usually a method to treat this condition by means of different techniques such as microvascular decompression and thus achieve disappearance of this disorder.

show abstract