دورية أكاديمية
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Preservation of cranial nerve function in large and giant trigeminal schwannoma resection: a case series.

التفاصيل البيبلوغرافية
العنوان: Preservation of cranial nerve function in large and giant trigeminal schwannoma resection: a case series.
المؤلفون: Findlay MC; Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 North Medical Drive East, Salt Lake City, UT, 84132, USA., Bounajem MT; Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 North Medical Drive East, Salt Lake City, UT, 84132, USA., Mortimer V; Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 North Medical Drive East, Salt Lake City, UT, 84132, USA., Budohoski KP; Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 North Medical Drive East, Salt Lake City, UT, 84132, USA., Rennert RC; Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 North Medical Drive East, Salt Lake City, UT, 84132, USA., Couldwell WT; Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 North Medical Drive East, Salt Lake City, UT, 84132, USA. neuropub@hsc.utah.edu.
المصدر: Acta neurochirurgica [Acta Neurochir (Wien)] 2024 Apr 29; Vol. 166 (1), pp. 198. Date of Electronic Publication: 2024 Apr 29.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer Country of Publication: Austria NLM ID: 0151000 Publication Model: Electronic Cited Medium: Internet ISSN: 0942-0940 (Electronic) Linking ISSN: 00016268 NLM ISO Abbreviation: Acta Neurochir (Wien) Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Wien, Springer.
مواضيع طبية MeSH: Neurilemmoma*/surgery , Cranial Nerve Neoplasms*/surgery , Cranial Nerve Neoplasms*/pathology , Microsurgery*/methods , Trigeminal Nerve Diseases*/surgery , Trigeminal Nerve Diseases*/pathology, Humans ; Male ; Female ; Adult ; Middle Aged ; Retrospective Studies ; Neurosurgical Procedures/methods ; Cranial Nerves/surgery ; Cranial Nerves/pathology ; Treatment Outcome ; Young Adult
مستخلص: Background: Trigeminal schwannomas (TSs) are intracranial tumors that can cause significant brainstem compression. TS resection can be challenging because of the risk of new neurologic and cranial nerve deficits, especially with large (≥ 3 cm) or giant (≥ 4 cm) TSs. As prior surgical series include TSs of all sizes, we herein present our clinical experience treating large and giant TSs via microsurgical resection.
Methods: This was a retrospective, single-surgeon case series of adult patients with large or giant TSs treated with microsurgery in 2012-2023.
Results: Seven patients underwent microsurgical resection for TSs (1 large, 6 giant; 4 males; mean age 39 ± 14 years). Tumors were classified as type M (middle fossa in the interdural space; 1 case, 14%), type ME (middle fossa with extracranial extension; 3 cases, 43%), type MP (middle and posterior fossae; 2 cases, 29%), or type MPE (middle/posterior fossae and extracranial space; 1 case, 14%). Six patients were treated with a frontotemporal approach (combined with transmastoid craniotomy in the same sitting in one patient and a delayed transmaxillary approach in another), and one patient was treated using an orbitofrontotemporal approach. Gross total resection was achieved in 5 cases (2 near-total resections). Five patients had preoperative facial numbness, and 6 had immediate postoperative facial numbness, including two with worsened or new symptoms. Two patients (28%) demonstrated new non-trigeminal cranial nerve deficits over mean follow-up of 22 months. Overall, 80% of patients with preoperative facial numbness and 83% with facial numbness at any point experienced improvement or resolution during their postoperative course. All patients with preoperative or new postoperative non-trigeminal tumor-related cranial nerve deficits (4/4) experienced improvement or resolution on follow-up. One patient experienced tumor recurrence that has been managed conservatively.
Conclusions: Microsurgical resection of large or giant TSs can be performed with low morbidity and excellent long-term cranial nerve function.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)
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فهرسة مساهمة: Keywords: Case series; Cranial nerve; Microsurgery; Resection; Trigeminal schwannoma
تواريخ الأحداث: Date Created: 20240429 Date Completed: 20240429 Latest Revision: 20240429
رمز التحديث: 20240501
DOI: 10.1007/s00701-024-06094-y
PMID: 38684564
قاعدة البيانات: MEDLINE
الوصف
تدمد:0942-0940
DOI:10.1007/s00701-024-06094-y