Trigeminal neuroma. A report of eleven cases.

The clinical features, diagnosis, and management of a series of 11 cases of trigeminal neuroma (four men, seven women; mean age 40 years) are summarized. Symptoms at presentation were generally those of cerebellopontine angle and petrous apex space occupying lesions. Computed tomography scanning and magnetic resonance imaging were found to provide the best preoperative localization of these lesions, allowing better planning of the surgical approach and thereby maximizing tumor exposure, an essential for any attempt at total excision, considering the large size (greater than 3 cm) of these tumors when diagnosed. A retromastoid incision and posterior fossa craniectomy or a combined suprainfratentorial approach was used. Total excision was possible in four cases. In seven cases, a macroscopic clearance was effected (operative mortality nil, excellent outcome occurred in ten of the 11 cases). There has been no clinical evidence of recurrence or ongoing tumor growth despite possibly subtotal excision.