Intracranial schwannomas of the lower cranial nerves.

OBJECTIVE

To present our experience in the diagnosis and management of 39 patients with lower cranial nerve schwannomas of the posterior fossa.

STUDY

DESIGN

A retrospective chart review of patient medical records.

SETTING

Tertiary care, academic medical center.

PATIENTS: All patients with intracranial lower cranial nerve schwannomas treated surgically in our institution between July 1998 and July 2005.

INTERVENTION: A retrosigmoid, transcondylar, or combined approach was used for tumor recurrence.

RESULTS

Thirty-nine patients underwent surgical resection, with complete tumor removal in 32, near-total resection in 5 patients, and subtotal tumor excision in 2 patients. Long-term (mean, 8.2 years) magnetic resonance imaging surveillance demonstrated recurrent tumor in 2 of 32 complete resections and slow regrowth in 2 of 7 patients with known residual disease. Only one of these four patients required reoperation.

DISCUSSION: Intracranial schwannomas of the lower cranial nerves are relatively uncommon and may present with subtle or no clinical symptoms. Successful surgical resection with low risk of tumor recurrence can be achieved with the retrosigmoid or transcondylar approach. Morbidity, in this series, was primarily related to lower cranial nerve deficits.