Sharma Bhawani Shankar, Ahmad Faiz Uddin, Chandra Poodipedi Sarat, Mahapatra Ashok Kumar
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi 110 029, India.
J Clin Neurosci. 2008 Jul;15(7):738-43. doi: 10.1016/j.jocn.2006.09.007. Epub 2008 Apr 8.
Trigeminal schwannomas (TS) are rare. Only a couple of series involving a large number of cases have been reported. In the present study we aimed to analyse the clinical characteristics of TS, the surgical approaches used to treat TS, and the outcomes for patients undergoing surgical treatment for TS via retrospective analysis of departmental records. Data for 68 patients treated for TS in the Department of Neurosurgery at the All India Institute of Medical Sciences between January 1993 and December 2005 were analysed. Most patients were in the fourth decade of life, with the duration of symptoms ranging from 1 month to 13 years. Twenty-nine TSs were classified as type A, 13 as type B and 26 as type C, depending upon size. A skull base approach was used in every surgically treated case. Of the 46 patients for whom radiological follow-up data were available, complete tumour excision was achieved in 35 cases (76%). Follow-up ranged from 3 months to 12 years (mean 62 months). One patient died and nine (15%) had permanent morbidity in the form of corneal opacity (5) or facial (2) or trochlear (2) nerve palsy. We conclude that trigeminal neuromas are best treated by total surgical resection, which yields acceptable results with low rates of mortality and permanent morbidity.
三叉神经鞘瘤(TS)较为罕见。仅有少数涉及大量病例的系列报道。在本研究中,我们旨在通过回顾性分析科室记录,分析TS的临床特征、治疗TS所采用的手术方法以及接受TS手术治疗患者的预后。对1993年1月至2005年12月期间在全印度医学科学研究所神经外科接受TS治疗的68例患者的数据进行了分析。大多数患者处于人生的第四个十年,症状持续时间从1个月至13年不等。根据大小,29例TS被归类为A型,13例为B型,26例为C型。每例接受手术治疗的病例均采用了颅底入路。在有放射学随访数据的46例患者中,35例(76%)实现了肿瘤全切。随访时间从3个月至12年(平均62个月)。1例患者死亡,9例(15%)出现永久性并发症,表现为角膜混浊(5例)或面部(2例)或滑车神经(2例)麻痹。我们得出结论,三叉神经鞘瘤最好通过手术全切治疗,该方法可取得可接受的结果,死亡率和永久性并发症发生率较低。