A Suggestion of Modified Classification of Trigeminal Schwannomas According to Location, Shape, and Extension
Brain Tumor Research and Treatment
;
: 62-68, 2014.
Article
in English
| WPRIM
| ID: wpr-8768
ABSTRACT
BACKGROUND:
Comprehensive knowledge of the anatomical features of trigeminal schwannomas (TSs) is essential in planning surgery to achieve complete tumor resection. In the current report, we propose a modified classification of TSs according to their location of origin, shape, and extension into the adjacent compartment, and discuss appropriate surgical strategies with this classification.METHODS:
We retrospectively analyzed 49 patients with TS who were treated surgically by a single neurosurgeon at the Asan Medical Center between 1993 and 2013.RESULTS:
There were 22 males and 27 females, with the median age of 40 years (range, 21-75 years). Median tumor size was 4.0 cm in diameter (2.0-7.0 cm). Tumors were classified as follows Type M (confined to the middle fossa; 8 cases, 19.0%), P (confined to the posterior fossa; 2 cases, 4.8%), MP (involving equally both middle and posterior fossae; 5 cases, 11.9%), Mp (predominantly middle fossa with posterior fossa extension; 6 cases, 14.3%), Pm (predominantly posterior fossa with middle fossa extension; 16 cases, 38.1%), Me (predominantly middle fossa with extracranial extension; 4 cases, 9.5%). Surgical approach was chosen depending on the tumor classification. More specifically, a frontotemporal craniotomy and extradural approach with or without zygomatic or orbitozygomatic osteotomy was applied to M- or Mp-type tumors; a lateral suboccipital craniotomy with or without suprameatal approach was applied to the majority of P- or Pm-type tumors; and a posterior transpetrosal approach was used in four tumors (three Pm and one MP). Gross total resection was achieved in 95.9% of patients, and the overall recurrence rate was 4.1% (2 patients). Postoperatively, trigeminal symptoms were improved or unchanged in 51.0% of cases (25 patients). Surgical complications included meningitis (5 patients) and cerebrospinal fluid leakage (3 patients). There was no mortality.CONCLUSION:
TSs are well to be classified with our modified classification and able to be removed effectively and safely by selecting appropriate surgical approaches.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Osteotomy
/
Recurrence
/
Trigeminal Nerve
/
Cerebrospinal Fluid
/
Retrospective Studies
/
Mortality
/
Classification
/
Craniotomy
/
Meningitis
/
Neurilemmoma
Type of study:
Observational study
/
Prognostic study
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Brain Tumor Research and Treatment
Year:
2014
Type:
Article
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