Different surgical modalities in the management of trigeminal schwannoma

Abstract

Introduction: Schwannomas are benign, slow-growing well-encapsulated tumors. Peripheral nerve sheath tumors are those that develop from Schwann cells that surround the peripheral or cranial nerves.AIM OF THE WORK: To assess the efficacy of various treatment modalities for trigeminal schwannoma. Patients and methods: From 2015 to 2019, 15 patients who had various surgical procedures to treat trigeminal schwannoma at Ain Shams University Hospitals and Nasser Institute Hospital were the subjects of a retrospective research.RESULTS: The tumors were right-sided in 60% of patients and 40% had left-sided tumors. 26.7% of patients had tumor class A, 20% had tumor class B & 53.3% had class C tumors. Retrosigmoid approach was used in 6.7% of patients, Frontotemporo-orbitozygomatic (FTOZ) Dolanc approach was used in 26.7%, FTOZ approach was used in 6.7%, transzygomatic extradural subtemporal approach was used in 6.7%, Dolanc extradural subtemporal approach was used in 26.7%, the extradural subtemporal approach was used in 6.7% & anterior petrosectomy (Kwase) approach was used in 20.0% of our study population. Partial resection was done for 26.7% of patients, Subtotal resection was done for 33.3% of patients, and complete resection was done for 40.0% of patients. The cavernous extension was present in 53.3% of patients, Gamma Knife postoperative was needed in 53.3% of patients & pathology was Trigeminal Schwannoma in 100% of our patients. Regarding Cavernous extension, there was a statistically significant difference between various methods. CONCLUSION: The optimum therapy for trigeminal schwannoma with a low complication rate may be total excision using the correct method.