Microsurgical treatment of trigeminal neurinomas with middle fossa extradural approach

Abstract

To investigate the effect of microsurgical treatment of trigeminal neurinomas with middle fossa extradural approach. Between January 1996 and December 2005, 27 patients with trigeminal schwannomas were treated by middle fossa extradural approach. The clinical data were retrospectively analyzed. Total resection was achieved in 25 patients and subtotal resection in the other 2 patients. The cranial nerve deficits were improved in 18 patients, unchanged in 4 patients and worsened in 5 patients postoperatively. New Incomplete paralysis of cranial nerve were observed in 4 patients. Cerebrospinal fluid leakages and bacterial meningitis occurred in 2 cases, which were cured by lumber draining and antibiotic therapy. There was not operative mortality. Twenty six patients were followed up for 6 - 48 months. Tumor recurrence was found in 1 case after 40 months and was excised again. This approach can provide better exposure of these tumors and multiple working angles with minimal brain retraction and can improve the surgical results in terms of increased complete tumor resection rate and reduced complications rate.