Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
Department of Neurosurgery, Xuzhou Central Hospital, Xuzhou, People's Republic of China.
Acta Neurochir (Wien). 2023 Dec;165(12):4157-4168. doi: 10.1007/s00701-023-05857-3. Epub 2023 Nov 24.
Advances in microscopic and endoscopic surgical techniques have outpaced traditional classification and transcranial surgical strategies, especially with reference to the treatment of trigeminal schwannomas (TSs). A modified TS classification is proposed and appropriate surgical strategies are discussed.
The cases of 93 patients who underwent surgical treatment in Beijing Tiantan Hospital in the previous 6 years were analyzed retrospectively, and a literature review was conducted.
Classification is based on surgical direction. Tumors were classified as follows: type A, backward orientation, located in the orbit or orbit and middle cranial fossa (8 cases, 8.6%); type B, upward orientation, located in the pterygopalatine fossa, infratemporal fossa or pterygopalatine fossa, infratemporal fossa, and middle cranial fossa (23 cases, 24.7%); type C, forward and backward orientations, located in the middle cranial fossa, posterior cranial fossa or both (58 cases, 62.4%); and type D, located in multiple regions (4 cases, 4.3%). 91.40% of patients underwent gross total resection (GTR) with 29 cases receiving endoscopic resection of whom 93.10% (27/29) experienced GTR.
The 93 cases were satisfactorily divided into four types, according to tumor location and surgical orientation, enabling safe and effective removal by appropriate surgery.
随着显微和内镜外科技术的进步，已经超越了传统的分类和经颅手术策略，尤其是在三叉神经鞘瘤（TSs）的治疗方面。提出了一种改良的 TS 分类，并讨论了相应的手术策略。
回顾性分析了过去 6 年在北京天坛医院接受手术治疗的 93 例患者的病例，并进行了文献复习。
分类基于手术方向。肿瘤分为以下类型：A 型，向后定位，位于眼眶或眼眶和中颅窝（8 例，8.6%）；B 型，向上定位，位于翼腭窝、颞下窝或翼腭窝、颞下窝和中颅窝（23 例，24.7%）；C 型，前后向定位，位于中颅窝、后颅窝或两者（58 例，62.4%）；D 型，位于多个部位（4 例，4.3%）。91.40%的患者行大体全切除（GTR），其中 29 例行内镜切除，93.10%（27/29）达到 GTR。
根据肿瘤位置和手术方向，93 例患者被满意地分为 4 型，通过适当的手术可以安全有效地切除。
