Surgical treatment of trigeminal neurinomas.

OBJECTIVE

To investigate the best surgical approach for the removal of trigeminal neurinomas (TNs).

METHODS

A retrospective analysis of 75' patients with TNs in Huashan Hospital was carried out.

RESULTS

In the early group (1978-1984), a series of conventional intradural approaches were used; in the late group (1985-1995), an epidural approach via the skull-base craniotomy was used. Total tumor removal was achieved in 58% (20/35) of patients in the early group and 80% (32/40) in the late group (P < 0.025). Temporary and permanent cranial nerve morbidity were 62.7% and 37% in the early group and 28.1% and 10% in the late group (P < 0.001).

CONCLUSION

The best microsurgical approach for the removal of trigeminal neurinomas except those confined to the posterior fossa is epidural approach or epidurotransduro-transtentorial approach via the skull-base craniotomy.