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J Neurol Surg B Skull Base 2019; 80(03): 264-269
DOI: 10.1055/s-0038-1669418
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Microsurgical Management of Trigeminal Schwannoma: Cohort Analysis and Systematic Review

Maick Willen Fernandes Neves
1   Department of Neurosurgery, Hospital Celso Pierro, Pontifícial Catholic University of Campinas, Campinas, São Paulo, Brazil
,
Paulo Henrique Pires de Aguiar
2   Department of Neurosurgery, Pontifícial Catholic University of Sorocaba, Sorocaba, São Paulo, Brazil
,
Telmo Augusto Barba Belsuzarri
1   Department of Neurosurgery, Hospital Celso Pierro, Pontifícial Catholic University of Campinas, Campinas, São Paulo, Brazil
,
André Monteiro Soares de Araujo
3   Department of Neurosurgery, Pontifícial Catholic University of Campinas, Campinas, São Paulo, Brazil
,
Samantha Lorena Paganelli
4   Department of Neurosurgery, Hospital Ramos Mejía, Buenos Aires University, CABA, Argentina
,
Marcos Vinicius Calfat Maldaun
5   Department of Neurosurgery, Santa Paula Hospital, São Paulo, São Paulo, Brazil
› Author Affiliations
Further Information

Publication History

25 April 2018

11 July 2018

Publication Date:
28 August 2018 (online)

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Abstract

Background Trigeminal schwannomas are benign tumors with a predilection for women between 40 and 60 years of age and account for less than 0.5% of all intracranial tumors. Clinical presentation depends on size and location, and typical symptoms are ipsilateral hypesthesia, headache, and facial pain. Clinical features and imaging usually make the Diagnosis.

Methods A retrospective cohort analysis of 14 patients treated at our institution between January 1999 and October 2016 was performed, with a critical and systematic review of data from the literature, focusing on articles published over the same period.

Results Fourteen patients were included in our series comprised of mostly women with a mean age of 40 years. Lesion size ranged from 3 to 6.5 cm (mean 4.6 cm). Clinical status of patients was evaluated and also rated based on the Karnofsky Perfomance Scale with values greater than 90% found in all patients pre and postoperatively. Surgery was our treatment of choice, and gross total resection was achieved in 71% of patients. Associated morbidity was high at 57%, predominantly from cranial nerve palsy, and no deaths were encountered.

Conclusions Microsurgery is a suitable treatment for large symptomatic trigeminal schwannomas, achieving good local control rates over the observation period at acceptable morbidity. Therefore, microsurgery appears to a suitable option. During the study period, a significant evolution in the availability of treatment methods occurred. Radiosurgery emerged as an alternative treatment for unresectable lesions. A comprehensive review of the available literature was performed, and results were compared according to treatment modality.

Keywords

brain tumor - trigeminal schwannoma - microsurgery - radiosurgery

Financial Support and Sponsorship

None.


 

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