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trigeminal schwannoma

Ramesh Sharanappa Doddamani, Rajesh Kumar Meena, Selvam Murali Mohan, Neelam Krishnan Venkatramanaa
Trigeminal schwannomas (TSs) are extremely rare tumors in childhood, particularly in the absence of neurofibromatosis. Although multi-staged surgical strategies have been reported in the literature, safe and single stage microsurgical removal is possible. We report a rare case of dumbbell TS, in a 9-year-old girl in whom single stage complete removal was done using fronto-temporo-orbito-zygomatic craniotomy and sub temporal approach.
January 2018: Asian Journal of Neurosurgery
John P Marinelli, Jamie J Van Gompel, Michael J Link, Matthew L Carlson
No abstract text is available yet for this article.
February 21, 2018: World Neurosurgery
Thien Nguyen, Courtney Duong, John P Sheppard, Seung Jin Lee, Amar U Kishan, Percy Lee, Stephen Tenn, Robert Chin, Tania B Kaprealian, Isaac Yang
Vestibular schwannomas (VS) are benign tumors stemming from the eighth cranial nerve. Treatment options for VS include conservative management, microsurgery, stereotactic radiosurgery, and fractionated radiotherapy. Though microsurgery has been the standard of care for larger lesions, hypo-fractionated stereotactic radiotherapy (hypo-FSRT) is an emerging modality. However, its clinical efficacy and safety have yet to be established. We conducted a systematic review and meta-analysis of manuscripts indexed in PubMed, Scopus, Web of Science, Embase, and Cochrane databases reporting outcomes of VS cases treated with hypo-FSRT...
March 2018: Clinical Neurology and Neurosurgery
Aijun Liang, Bin Xi, Chaoyang Zhou, Yu Yang, Jianzhong Zhang, Shaogao Gui, Fanghua Xu, Dengfeng Wan
Although benign trigeminal schwannomas are uncommon, malignant peripheral nerve sheath tumors (MPNSTs) of the trigeminal nerve are extraordinarily rare. This study aimed to describe an exceedingly rare case of MPNST of the trigeminal nerve involving the middle and posterior cranial fossa. Only 20 similar cases of MPNSTs of the trigeminal nerve have been reported so far. The clinical characteristics and management of these extremely rare tumors have also been explored in this study.
February 2, 2018: World Neurosurgery
Huy Q Truong, Xicai Sun, Emrah Celtikci, Hamid Borghei-Razavi, Eric W Wang, Carl H Snyderman, Paul A Gardner, Juan C Fernandez-Miranda
OBJECTIVE Multiple approaches have been designed to reach the medial middle fossa (for lesions in Meckel's cave, in particular), but an anterior approach through the greater wing of the sphenoid (transalisphenoid) has not been explored. In this study, the authors sought to assess the feasibility of and define the anatomical landmarks for an endoscopic anterior transmaxillary transalisphenoid (EATT) approach to Meckel's cave and the middle cranial fossa. METHODS Endoscopic dissection was performed on 5 cadaver heads injected intravascularly with colored silicone bilaterally to develop the approach and define surgical landmarks...
February 2, 2018: Journal of Neurosurgery
Aviral Agrawal, Virendra Singh, Seema Rohilla, Bindu Sharma
Schwannoma is a benign tumor of the nerve sheath arising from the perineural schwann cells. The nerves most commonly involved in schwannomas of the head and neck are the vagus and the cervical sympathetic chain. Trigeminal schwannomas are rare tumours. A 17 year old male patient with a chief complaint of swelling on face was diagnosed as suffering from bening tumor extending from cranial base (from foramen ovale) to the parapharengeal space. Mandibular access osteotomy was done to expose the tumor. Surgical excision of the tumor was done along with the preservation of the nerve...
July 2017: National Journal of Maxillofacial Surgery
Lu Yang, Li Hu, Weidong Zhao, Huankang Zhang, Quan Liu, Dehui Wang
BACKGROUND: The anatomical locations involved in trigeminal schwannomas (TSs) are quite complex. The endoscopic endonasal approach provides a minimal damage access corridor to both anterior and middle skull base for surgery. Given the nerve function recovery and postoperative neurological deterioration varied in different reports, the author demonstrates his surgery tips and the functional outcomes under endoscopic surgery in one single institution. METHODS: A retrospective review of patients with TSs was undertaken to assess the outcome of endoscopic surgery from 2006 to 2016...
March 2018: European Archives of Oto-rhino-laryngology
Luke Galloway, Nachi Palaniappan, Geoffrey Shone, Caroline Hayhurst
BACKGROUND: Trigeminal neuropathy (TGN) can occur as a presenting feature of vestibular schwannoma (VS) or as an adverse effect of radiosurgery. This study was designed to evaluate a treatment algorithm for presenting symptoms of TGN in patients with VS, and a new radiosurgery dosimetric tolerance to avoid TGN after treatment. Outcome was measured after microsurgery (MS), stereotactic radiosurgery (SRS), hypofractionated stereotactic radiotherapy (HSRT), and fractionated radiotherapy (FRT)...
January 17, 2018: Acta Neurochirurgica
Anne-Marie Langlois, Christian Iorio-Morin, Laurence Masson-Côté, David Mathieu
BACKGROUND: Nonvestibular cranial schwannomas represent a rare type of benign intracranial tumor. Few studies have evaluated the use of stereotactic radiosurgery (SRS) as a primary management option for these lesions. We performed a retrospective review of our institution's experience focusing on efficacy with regard to tumor control and clinical symptom stabilization as well as treatment safety. METHODS: Patients were included if they underwent at least 1 SRS procedure for a nonvestibular schwannoma and had at least 6 months of available imaging follow-up...
February 2018: World Neurosurgery
Jeffrey H Zimering, Jonathan J Stone, Audrey Paulzak, John D Markman, Mahlon D Johnson, G Edward Vates
The authors report the case of a 52-year-old man who presented with rapid-onset lancinating facial pain consistent with trigeminal neuralgia. Magnetic resonance imaging revealed a nonenhancing small lesion on the right trigeminal nerve concerning for an atypical schwannoma or neuroma. The patient underwent resection of the mass via a right retrosigmoid approach. His facial pain completely resolved immediately postoperatively and had not recurred at 6 months after surgery. The mass was consistent with normal brain tissue (neurons and glial cells) without evidence of mitoses...
December 1, 2017: Journal of Neurosurgery
Daniel Q Sun, Arnold H Menezes, Matthew A Howard, Bruce J Gantz, David M Hasan, Marlan R Hansen
OBJECTIVE: To study the indications and outcomes of lateral sphenoidectomy as part of a combined skull base approach in the treatment of tumors involving Meckel's cave (MC) and cavernous sinus (CS). STUDY DESIGN: Retrospective patient series. SETTING: Tertiary referral center. PATIENTS: Twenty-two consecutive patients (mean age: 45 yr, range: 16-76) who underwent transzygomatic, extended middle fossa approaches for tumors involving MC and CS...
January 2018: Otology & Neurotology
Yosuke Sato, Tohru Mizutani, Katsuyoshi Shimizu, Hans-Joachim Freund, Madjid Samii
BACKGROUND: Surgical removal of giant vestibular schwannomas with severe petrous bone involvement remains challenging due to the high risk of complications. The retrosigmoid intradural suprameatal-inframeatal approach (RISIA) allows for safe exposure extending from Meckel's cave to the petrous internal carotid artery (ICA). CASE DESCRIPTION: A 27-year-old man presented with recurrence of a giant vestibular schwannoma (4.5 cm) invading Meckel's cave and the left petrous ICA...
February 2018: World Neurosurgery
Youngbeom Seo, Dong Gyu Kim
We present a rare case of vestibular schwannoma (VS) with contralateral trigeminal neuralgia. A 59 year-old woman presented with right-sided trigeminal neuralgia and a small VS in the left cerebellopontine angle (CPA) that was found via magnetic resonance imaging. The patient was administered medication; however, her symptoms gradually aggravated, and the size of the tumor increased. Two years after the initial diagnosis, the patient underwent surgical resection. After surgical resection, the patient's facial pain was improved...
October 26, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Blandine Lourenço, Béatriz Madero, Stéphane Tringali, Xavier Dubernard, Toufic Khalil, André Chays, Arnaud Bazin, Thierry Mom, Paul Avan
In vestibular-schwannoma (VS) surgery, hearing-preservation rate remains low. Besides damage to the cochlear nerve, intraoperative cochlear ischemia is a potential cause of hearing loss. Here, we used non-invasive cochlear microphonic (CM) recordings to detect the cochlear vascular events of VS surgery. Continuous intraoperative CM monitoring, in response to 80-95 dB SPL, 1-kHz tone-bursts, was performed in two samples of patients undergoing retrosigmoid cerebellopontine-angle surgery: one for VS (n = 31) and one for vestibular neurectomy or vasculo-neural conflict causing intractable trigeminal neuralgia, harmless to hearing (n = 19, control group)...
October 27, 2017: European Archives of Oto-rhino-laryngology
Andrea Lo, Gareth Ayre, Roy Ma, Fred Hsu, Ryojo Akagami, Michael McKenzie, Boris Valev, Ermias Gete, Isabelle Vallieres, Alan Nichol
PURPOSE: To examine long-term local control of vestibular schwannoma and side effects in patients treated with stereotactic radiosurgery (SRS) and fractionated stereotactic radiation therapy (SRT) in British Columbia. METHODS AND MATERIALS: From August 1998 to May 2009, 207 patients were treated with radiation therapy (RT) at British Columbia Cancer Agency. 136 (66%) received SRS, and 71 (34%) received SRT. Dose prescriptions were 50 Gy/25 fractions for SRT and 12 Gy/1 fraction for SRS...
February 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Victor X Fu, Jeroen B Verheul, Guus N Beute, Sieger Leenstra, Henricus P M Kunst, Jef J S Mulder, Patrick E J Hanssens
OBJECTIVE Gamma Knife radiosurgery (GKRS) has become an accepted treatment for vestibular schwannoma, with a high rate of tumor control and good clinical outcome. In a small number of cases, additional treatment is needed. This retrospective study examines the clinical outcome, reproducibility of volumetric response patterns, and tumor control rate after administering a second GKRS to treat vestibular schwannomas. METHODS A total of 38 patients were included: 28 patients underwent a radiosurgical procedure as the initial treatment (Group 1), and 10 patients underwent microsurgical resection with adjuvant radiosurgery on the tumor remnant as the initial treatment (Group 2)...
October 6, 2017: Journal of Neurosurgery
Xiaosheng He, Weiping Liu, Yangang Wang, Jun Zhang, Buqing Liang, Jason H Huang
Background Meningiomas follow schwannomas as the second most common cerebellopontine angle (CPA) tumors. We investigate the diagnosis, management, and prognosis of this disease. Methods We reviewed the cases with the CPA meningiomas in our institution in Shaanxi, China from January 2012 to December 2015. Charts were retrospectively examined and patients were divided into two groups: 1) surgical treatment with a retrosigmoid approach for tumor resection and 2) stereotactic radiosurgery treatment only. Patients were followed up and outpatient records were also reviewed...
August 3, 2017: Curēus
Giuseppe Mariniello, Oreste de Divitiis, Ferdinando Caranci, Flavia Dones, Francesco Maiuri
BACKGROUND: Schwannomas of the parasellar region may arise from the trigeminal, oculomotor, trochlear, and abducens nerves. OBJECTIVE: To define the tumor origin, location, and dural relationship (extradural vs extra-intradural vs cisternal) on preoperative magnetic resonance imaging (MRI), in order to plan the best surgical approach (purely extradural vs extra-intradural). METHODS: Twenty-four patients with parasellar schwannomas who underwent surgery were retrospectively analyzed...
August 22, 2017: Operative Neurosurgery (Hagerstown, Md.)
Andrew A Fanous, Dheerendra Prasad, David Mathieu, Andrew J Fabiano
Stereotactic radiosurgery (SRS) is the use of a single high dose of radiation, stereotactically directed to an intracranial region of interest, in order to create a lesion or obliterate a preexisting one. This technology has evolved over the years into the use of multiple radiation sources oriented at a variety of angles, thus permitting the creation of various treatment target shapes. This allows for non-open surgical treatment of intracranial pathologies, which significantly decreases the risk of morbidity...
September 22, 2017: Journal of Neurosurgical Sciences
Ji Hee Kim, Hyun Ho Jung, Jong Hee Chang, Jin Woo Chang, Yong Gou Park, Won Seok Chang
OBJECTIVE: Gamma Knife radiosurgery (GKS) for the treatment of vestibular schwannoma (VS) introduces risks to the facial nerve and auditory perception and may involve post-treatment complications such as pseudoprogression, hydrocephalus, and other cranial neuropathies. This study of patients with VS who underwent GKS investigated radiosurgical results, focusing on post-treatment complications and identifying the factors that predict such complications. METHODS: We undertook a retrospective review of all VS patients treated with the Perfexion Leksell Gamma Knife between November 2007 and October 2010 at our institution...
November 2017: World Neurosurgery
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