Trigeminal Schwannomas

Wanibuchi, Masahiko; Fukushima, Takanori; Zomordi, Ali R; Nonaka, Yoichi; Friedman, Allan H.

doi:10.1227/neu.0b013e31822efb21

Cited by 63 publications

(91 citation statements)

References 50 publications

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“…Additionally, in the trigeminal cystic schwannoma the cystic portion is identified as a hypointense area in T1, without enhancement after administration of gadolinium and isointense when compared to the solid portion in T2 sequences. When evaluating the mass in FLAIR, the nodular and cystic portion has high signal intensity [1], [2], [3], [4], [5].…”

Section: Discussionmentioning

confidence: 99%

“…The first, proposed by Wanibuchi et al, [4] trigeminal schwannomas are divided depending on the origin of the lesion; he classifies them in peripheral, Meckel cave, posterior fossa root or dumbbell. Peripheral tumors are those originating in the extracranial portions of the trigeminal nerve, compromising its divisions V1, V2 or V3.…”

Section: Discussionmentioning

confidence: 99%

“…For intra and interdural tumors, cranial base approaches are preferred, since they allow a better trigeminal exposure, minimizing cerebral retraction [16,17]. On the other hand, in those tumors of V1, the temporopolar approaches are the ones of choice, while those originating in V2 and V3 infratemporal resection is preferred, allowing the exposure of the foramen ovale, the pterygopalatine ganglion and the infratemporal fossa [4,18]. For the lesions located in the Meckel cave, the pericavernosal lateral approach is preferred, with which the lesion of the trochlear and abducens nerves is diminished [4,19,20].…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 25%-40% occur in the soft tissues of the head and neck [1], usually from the vestibulocochlear nerve. Trigeminal nerve is the second most common intracranial location [2,3], however these is a rare entity, responsible only for 0.07%-0.36% of intracranial tumors [4,5]. According to their radiological characteristics, schwannomas are classified as solid or cystic, with cystic presentation being the most unusual, with a reported incidence of less than 7%, of all trigeminal schwannomas [4,6].…”

Section: Introductionmentioning

confidence: 99%

“…Trigeminal nerve is the second most common intracranial location [2,3], however these is a rare entity, responsible only for 0.07%-0.36% of intracranial tumors [4,5]. According to their radiological characteristics, schwannomas are classified as solid or cystic, with cystic presentation being the most unusual, with a reported incidence of less than 7%, of all trigeminal schwannomas [4,6]. Two cases of trigeminal cystic schwannoma are documented, and a review of the literature is performed emphasizing its clinical presentation, magnetic resonance imaging (MRI) imaging features and its classification.…”

Section: Introductionmentioning

confidence: 99%

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Cystic trigeminal schwannomas

Ortega-Merchan

Reyes

Mejía

et al. 2019

Radiology Case Reports

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Trigeminal Schwannomas are less than 1% of intracranial tumors, of which only 7% have a cystic component. We documented 2 cases of males with cystic trigeminal Schwannomas, their symptoms, the diagnosis process and the imaging characteristics. In addition, a review of the literature is performed, with emphasis on the radiological classification of this rare entity, that constitutes a diagnostic challenge for the radiologist, who has an essential role in the approach to the disease and therefore in its management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Cystic trigeminal schwannomas

Ortega-Merchan

Reyes

Mejía

et al. 2019

Radiology Case Reports

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ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

141

279

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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Endoscopic Endonasal Approach for Trigeminal Schwannomas: Tailored Approaches Based on Lesion Traits

Pan

et al. 2023

The Laryngoscope

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ObjectivesTo describe four endoscopic endonasal subapproaches, namely, the trans‐lamina papyracea, trans‐prelacrimal recess, trans‐Meckel's cave, and transclival approaches for trigeminal schwannomas (TSs).MethodsThis retrospective study reviewed the medical records and intraoperative videos of 38 patients with TSs who underwent endoscopic endonasal approach (EEA) between Jan 2013 and Dec 2021.ResultsAccording to Jeong's classification, for TS equally in middle and posterior fossae (MP), a purely trans‐Meckel's cave approach was carried out in 2 cases, and a combined transclival approach was carried out in 4 cases. The four tumors that involved infratemporal fossa (two E3, one mE3, and one Mpe3) were performed via a trans‐prelacrimal recess approach, and type Mpe3 was also assisted by the trans‐Meckel's cave approach. One patient with type E1 was treated with a trans‐lamina papyracea approach. The other 27 cases, including type M, Mp, ME2, and MpE2, were all removed by a purely trans‐Meckel's cave approach. Thirty‐six patients (97.4%) received total resection under a purely EEA. The functional abilities and preoperative symptoms of 31 patients (88.6%) improved. Eight (21.1%) patients experienced permanent neurological function deficits. Postoperative cerebrospinal fluid and intraoperative internal carotid artery injury occurred in 1 (2.6%) patient.ConclusionAccording to the specific endoscopic endonasal subapproaches corresponding to the different TS locations, satisfactory results can be obtained for most types of tumors. It represents an effective alternative to the open transcranial approach and can also be properly used in most types of TS with experienced hands.Level of Evidence4 Laryngoscope, 133:2564–2571, 2023

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Trigeminal Schwannomas

Abstract: The present series demonstrates acceptable results using microsurgical treatment to remove trigeminal schwannomas. Pain and diplopia may be relieved after surgery; however, hypesthesia frequently remains or may be worsened by surgery.

Cited by 63 publications

References 50 publications

Cystic trigeminal schwannomas

Cystic trigeminal schwannomas

ICAR: endoscopic skull‐base surgery

Endoscopic Endonasal Approach for Trigeminal Schwannomas: Tailored Approaches Based on Lesion Traits

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