caa a22 4500 445329416 CHVBK 20180317142732.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s10143-010-0289-y doi (NATIONALLICENCE)springer-10.1007/s10143-010-0289-y Trigeminal schwannomas: experience with 57 cases and a review of the literature [Elektronische Daten] [Raita Fukaya, Kazunari Yoshida, Takayuki Ohira, Takeshi Kawase] Trigeminal schwannoma is a mostly benign tumor that can be cured by complete resection. Over the last few decades, several pioneers have developed surgical approaches enabling the total removal of such tumors. We analyzed 57 patients who underwent radical surgery, including 45 patients who underwent skull base surgery as their initial treatment, for removal of trigeminal schwannomas. Here, we report the surgical management of these cases. Since 1990, all such patients have been treated using three main types of middle fossa skull base approaches, which minimize the exposure of the brain: the anterior transpetrosal approach, subtemporal interdural approach (Dolenc), or a combination of these approaches. Before 1990, total tumor removal was achieved in only three of eight patients (38%). After 1990, the tumors were totally removed in 43 patients (90%) and were nearly completely removed in an additional three patients (6%). Among the patients who underwent skull base surgery as their initial treatment, a complete resection was achieved in 93% (42/45 patients) of the cases. However, total surgical removal after surgery and Gamma knife surgery was very difficult because of dense adhesions to the brain stem and cranial nerves. No surgery-related mortalities occurred in this series, and the individual KPS scores were more than 90% among the patients who underwent skull base surgery. No recurrences requiring additional surgery have occurred after an average follow-up period of 4.9years. Most of the trigeminal schwannomas could be removed totally and safely during a single operation after the introduction of skull base surgery. Therefore, radiosurgery should not be applied as the treatment of first choice for younger patients. A correct anatomical knowledge is critical for minimizing brain exposure and avoiding surgical complications. Springer-Verlag, 2010 Trigeminal nerve nationallicence Schwannoma nationallicence Skull base nationallicence Anatomy nationallicence Surgical technique nationallicence Radiosurgery nationallicence Fukaya Raita Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut Yoshida Kazunari Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut Ohira Takayuki Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut Kawase Takeshi Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut Neurosurgical Review Springer-Verlag 34/2(2011-04-01), 159-171 0344-5607 34:2<159 2011 34 10143 https://doi.org/10.1007/s10143-010-0289-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10143-010-0289-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fukaya Raita Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut NATIONALLICENCE 700 1- Yoshida Kazunari Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut NATIONALLICENCE 700 1- Ohira Takayuki Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut NATIONALLICENCE 700 1- Kawase Takeshi Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, 160-8582, Shinjuku-ku, Tokyo, Japan aut NATIONALLICENCE 773 0- Neurosurgical Review Springer-Verlag 34/2(2011-04-01), 159-171 0344-5607 34:2<159 2011 34 10143 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer