Diagnosis and surgical treatment of trigeminal neurinoma

ObjectiveTo report the experience of diagnosis and microsurgical treatment of patients with trigeminal neurinoma. MethodsThe clinical manifestations, preoperative CT and MRI features, operative techniques, and outcome of 13 patients with trigeminal neurinoma were retrospectively analyzed. ResultsThe most frequent symptoms were either pain or numbness of the ipsilateral, which was due to the dysfunction of the trigeminal nerve. CT and MRI were the major means for diagnosis of the lesions. Five patients had tumors limited to the middle cranial fossa, 8 patients had dumbbell shaped tumors which extended into both the middle and posterior cranial fossa. Postoperatively, 12 of the 13 patients had either stable or improved function of cranial nerves compared with their preoperative status, and the other one worsened. Total resection of tumor was accomplished by extradural approach in 11 patients. Subtotal removal were achieved in 2 patients. None of the patients had new cranial nerves deficits after the operation. There were no perioperative deaths. Ten patients were followed-up, ranging from 6 to 36 months. None recurred. ConclusionMRI is considered the best method for diagnosing the trigeminal neuromas. It is suggested that trigeminal neuromas, either in the middle cranial fossa or both in the middle and posterior fossa, can be safely and radically removed by extradural approach, which can lead to lower morbidity and postoperative complications.