Trigeminal Neurinomas: Report of 8 Cases with Special Reference to Operative Approach

ABSTRACT

The authors have treated eight cases of trigeminal neurinomas for the past thirteen years. We have been treating these tumors in accordance with the principle of radical resection through one-staged operation. Three were male and five were female. The age ranged from 25 to 56 years with the mean age of 41.5 years. One was a case of von Recklinghausen's disease. Topographically, the tumors were mainly located within the middle fossa in two cases, within the posterior fossa in two, and extended both supra- and infratentorially in four cases. Facial pain and hearing disturbance were the main symptoms and various other symptoms such as focal seizure, hemiparesis, gait disturbance, symptoms of increased intracranial pressure and visual disturbance were also noted. Surgical operations were performed in all cases. As a surgical approach, either transpetrosal-transtentorial or orbitozygomatic-infratemporal route was employed. The choice of the better approach depends on the topography of the tumor. Total removal was performed in all cases. Only one case, which was an early one in this series required second operation to remove the tumor completely. In one case, the tumor recurred five years after the operation. There has been no operative mortality, but the injury or permanent damage to the trigeminal branches was inevitable in many cases. Surgical results were excellent in three, good in four, and fair in one case.