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KMID : 1037420070020020068
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Journal of Korean Skull Base Society
2007 Volume.2 No. 2 p.68 ~ p.73
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Treatment Strategy of Trigeminal Schwannoma
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Kim Min-Su
Lee Jung-Il
Kim Jong-Hyun
Park Kwan
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Abstract
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Objective : The objective is to clarify the role of multimodality treatment of trigeminal schwannomas and to suggest optimal treatment strategy for these tumors.
Methods : From 1995 to April 2007 we had treated 52 patients with trigeminal schwannomas and the clinical data of these patients were analyzed retrospectively. There were 24 males and 28 females with mean age of 44.9 years (range 7-75 years). Surgical treatment was done in 43 patients and 8 patients of them were treated with a postoperative radiosurgery. 9 patients underwent radiosurgery on the basis of clinical findings and imaging criteria. Tumors that belong to type A (21 cases), which were predominantly in the middle cranial fossa; type B (9 cases), which presented predominantly in the cerebellopontine angle; type C (21 cases), which were dumbbellshaped extending into both the middle and posterior fossa; and type D (1 case), which was primarily extracranial with intracranial extension.
Results : The mean follow-up period was 36.9 months (range 5-129 months). In surgical treatment group, total tumor resections were achieved in 33 of 43 patients (77%). Three patients underwent the second staged operation to remove a residual or recurrent mass and all of them were type C. In radiosurgical treatment group, the tumor growth controls were achieved in 16 of 17 patients (94%).
Conclusion : Trigeminal schwannomas may be successfully removed with low morbidity in many patients, via an entirely subtemporal extradural approach. In patients with residual or newly diagnosed small sized trigeminal schwannomas, stereotactic radiosurgery may be a good adjuvant therapy.
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KEYWORD
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Trigeminal schwannoma, Subtemporal extradural approach, Radiosurgery
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