DIFFERENT SURGICAL MODALITIES IN THE MANAGEMENT OF TRIGEMINAL SCHWANNOMAS

El-Bahy, Khaled; Desouky, Ahmad E; Darwish, Assem M; Hamza, Emad Maamon

doi:10.21608/asmj.2022.285455

DIFFERENT SURGICAL MODALITIES IN THE MANAGEMENT OF TRIGEMINAL SCHWANNOMAS

Document Type : Original Article

Authors

¹ Neurosurgery department, Faculty of medicine, Ain shams university, Abbasya, Cairo, Egypt

² Neurosurgery department, Faculty of medicine, Ain shams university, Cairo, Egypt. Nasser institute, neurosurgery department, 1351 Nile Corniche, Agha Khan, Cairo, Egypt.

10.21608/asmj.2022.285455

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.

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