Goel Atul, Muzumdar Dattatraya, Raman Chandrashekhar
Department of Neurosurgery, King Edward VII Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Parel, Mumbai, India.
Neurosurgery. 2003 Apr;52(4):783-90; discussion 790. doi: 10.1227/01.neu.0000053365.05795.03.
We reviewed the clinical and radiological features of 73 cases of trigeminal neuromas treated with radical surgery.
The records for 73 patients with trigeminal neuromas who were surgically treated in the neurosurgery department of King Edward VII Memorial Hospital and Seth Gordhandas Sunderdas Medical College (Mumbai, India), between 1989 and 2001, were retrospectively analyzed. The appropriateness of the selected surgical route was studied. The postoperative and follow-up data for the patients were analyzed, to determine the outcomes of radical surgery.
In addition to the other presenting features of trigeminal neuromas, nine patients presented with the rarely reported symptom of pathological laughter. Three approaches were observed to be appropriate for treatment of these tumors, i.e., the infratemporal fossa interdural approach, the lateral basal subtemporal approach, and the retrosigmoid approach. In 51 cases (70%), total tumor excision was achieved. Two patients died during the postoperative period. With an average follow-up period of 38 months, there has been a recurrence in 1 case and 71 patients are leading independent and active lives.
Radical surgery is associated with excellent clinical outcomes and long-term tumor control. A majority of tumors, even those that are large and multicompartmental, can be removed in a single surgical stage and exposure.
我们回顾了73例接受根治性手术治疗的三叉神经鞘瘤的临床和影像学特征。
回顾性分析了1989年至2001年间在印度孟买爱德华七世纪念医院和塞思·戈尔丹达斯·桑德达斯医学院神经外科接受手术治疗的73例三叉神经鞘瘤患者的病历。研究了所选手术入路的合理性。分析患者的术后及随访数据，以确定根治性手术的结果。
除三叉神经鞘瘤的其他表现特征外，9例患者出现了罕见报道的病理性大笑症状。观察到三种入路适用于这些肿瘤的治疗，即颞下窝硬膜间入路、外侧基底颞下入路和乙状窦后入路。51例（70%）实现了肿瘤全切。2例患者在术后死亡。平均随访38个月，1例复发，71例患者过着独立且积极的生活。
根治性手术具有良好的临床效果和长期的肿瘤控制。大多数肿瘤，即使是那些大的和多房性的肿瘤，也可以在单一手术阶段和暴露下切除。
