Trigeminal complications arising after surgery of cranial base meningiomas

Westerlund, Ulf; Linderoth, Bengt; Mathiesen, Tiit

doi:10.1007/s10143-011-0355-0

Cited by 14 publications

(9 citation statements)

References 40 publications

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“…No matter the symptoms were a persistent (caused by tumor) or de novo disease (caused by surgery), this sensory complication particularly affects the postoperative quality of life, which plays a critical role in patient satisfaction with surgical outcome. 8,27 In this study, we also found an association between the TSN distribution and gustatory dysfunction. All patients complaining about TSN had a lower gustatory function on the affected side.…”

Section: Discussionsupporting

confidence: 75%

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Trigeminal Sensory Neuropathy Predicts Chemosensory Dysfunction After Skull Base Surgery

Podlesek

Chao

Weitkamp

et al. 2022

Operative Neurosurgery

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BACKGROUND: Trigeminal sensory neuropathy, characterized by diminished or exaggerated/painful sensation along the distribution of trigeminal branches, is one of the complications after skull base surgery. These procedures can also affect chemosensory functions and compromise the patients' quality of life. OBJECTIVE: To examine those postoperative complications in chemosensory and facial cutaneous sensory functions as well as their interaction. METHODS: A total of 61 patients being operated for various pathologies in the vicinity of trigeminal pathway (17 with trigeminal neuralgia, 20 with meningiomas, and 24 with vestibular schwannomas) and 50 healthy controls were enrolled in this case-control study. Postoperative trigeminal neuropathic symptoms were evaluated. The olfactory, gustatory, and intranasal trigeminal functions were assessed using the Sniffin' Stick olfactory test, lateralized taste strip test, and the lateralized intranasal trigeminal CO 2 detection thresholds, respectively. RESULTS: Patients with trigeminal neuralgia and meningioma had relatively decreased olfactory function, whereas those with vestibular schwannoma had a relative decrease in taste function. As for the relationship between the distribution of trigeminal neuropathy and chemosensory dysfunction, we found that V3 involvement predicted lower sidespecific taste function. In addition, V2/V3 involvement predicted relatively lower sidespecific intranasal trigeminal function. CONCLUSION: The present results suggest a differential involvement of the chemical senses in relation to the site and pathology of the lesions after surgery. The presence of trigeminal neuropathy is associated with taste and intranasal trigeminal dysfunction. The results serve as a basis for consultation regarding outcome prediction and patient education.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Trigeminal Sensory Neuropathy Predicts Chemosensory Dysfunction After Skull Base Surgery

Podlesek

Chao

Weitkamp

et al. 2022

Operative Neurosurgery

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“…The etiology of trigeminal nerve injury varies and it involves trigeminal nerve ablation, cerebrovascular accidents, surgical complications, trauma and herpes zoster infection (5,6,11,12) . A rare condition that is associated with trigeminal nerve palsy is TTS.…”

Section: Discussionmentioning

confidence: 99%

Nasal alar deformity: a very rare complication of acoustic neuroma surgery after ipsilateral trigeminal and facial nerve paralysis

Ieridou¹,

Printza²,

Tsinaslanidou³

et al. 2018

RHINOL

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Background: Nasal alar deformity (NAD) can affect both nasal breathing and the aesthetic appearance of the nose. NAD can be congenital or acquired. The acquired causes include nerve palsies, traumatic or iatrogenic. A rare condition that is associated with NAD is trigeminal trophic syndrome (TTS). TTS is an uncommon disorder of the trigeminal nerve characterized by a triad of facial ulcers, with anesthesia and paresthesia of the involved dermatomes. Nasal alar reconstruction is challenging for the surgeon and when it is performed, a delicate balance between aesthetic and functional outcome should be considered. Case report: A 37 years old woman presented with nasal alar deformity caused by facial and trigeminal nerve paralysis after brain surgery. The woman was diagnosed with an acoustic neuroma and underwent complete tumor removal from neurosurgeons. After surgery, the patient suffered from facial and trigeminal nerve paralysis and 4-years later she presented with a progressive nasal alar deformity accompanied by breathing and aesthetic dysfunction. Reconstruction of the nasal ala was performed in one-stage surgery using spreader, alar batten and rim grafts. Seven years postoperatively, our patient had good nasal breathing and did not show any alar collapse. Conclusions: In our case we believe that facial and trigeminal nerve palsies as a result of brain surgery, have both contributed to the deformity of the nasal ala. Reconstruction with the optimal technique and graft guaranteed long term results.

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“…Even the data on neurocognitive toxicity related to Whole brain RT are still contradictory 24 . White matter changes and cognition problems after SRS have been reported to occur in 0 to 12% of patients 5,50,97,119,131,151 . There are several identified predisposing factors that contribute to overall neurocognitive decline after brain irradiation, including tumor histology, volume and location, surgery, RT and chemotherapy.…”

Section: Cognitive Declinementioning

confidence: 99%

The Downside of Radiosurgery, Possible Complications

Pereira¹,

Modesto²

2018

jbnc

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As a consequence of various last century scientific and technological advances radiotherapy and stereotactic radiosurgery (SRS) have emerged as safe and efficacious techniques for the treatment of various intracranial pathologies. Recent improvements such as in brain and tumor imaging, patient immobilization, 3D planning and radiation delivery allow it to target lesions more accurately and minimize radiation delivered to normal brain, leading to drastic improvements in terms of safety and post-therapy complication. Despite that SRS still implies in moderate to severe side effects in one fifth to one fourth of patients. Fortunately the most common SRS complications, such as edema, blood brain barrier breakdown and MRI abnormalities are self-limited and amenable to treatment. The precise pathophysiological processes of SRS complications are still under research, however multiple factors including treatment dose, modality and planning complexity, target size, shape and location are known to affect treatment results. The most reported potential SRS complications are ischemic stroke, brain or lesion hemorrhage, radiosurgeryinduced neoplasm, radiation necrosis, white matter changes, cranial nerve dysfunction and cognition problems. SRS induced neurological complications may persist only in as much as 5% of patients.

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Trigeminal complications arising after surgery of cranial base meningiomas

Cited by 14 publications

References 40 publications

Trigeminal Sensory Neuropathy Predicts Chemosensory Dysfunction After Skull Base Surgery

Trigeminal Sensory Neuropathy Predicts Chemosensory Dysfunction After Skull Base Surgery

Nasal alar deformity: a very rare complication of acoustic neuroma surgery after ipsilateral trigeminal and facial nerve paralysis

The Downside of Radiosurgery, Possible Complications

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