Dolenc V V
Department of Neurosurgery, University Hospital Center, Ljubljana, Slovenia.
Acta Neurochir (Wien). 1994;130(1-4):55-65. doi: 10.1007/BF01405503.
From 1980 through 1993 a series of 44 patients with trigeminal neurinomas was treated. Five of them were operated on for the remainder of the tumour as they had undergone previous surgery elsewhere, 35 were operated on for the first time, and 4 were not operated on for various reasons. An epidural approach to the neurinomas originating in the branches of the Vth nerve peripherally to the Gasserian ganglion (GG) was used. In the neurinomas originating in the GG or in the root of the Vth nerve, either an epidural-transdural approach or an epidural-transdural-transpetrous approach was used. All tumours operated on using the approach described in this article were completely removed. In 10 patients, the Vth nerve sensory deficits increased in comparison with preoperative deficits; in 9 their state remained unaltered; and in 11 the sensory function of the Vth nerve improved. In those patients who had experienced pre-operative atypical trigeminal pain, the pain disappeared after surgery. There was no additional treatment: radiosurgery, irradiation or chemotherapy. Histopathological examination did not reveal any malignant changes in the tumours in any of the patients. Based on our own experience and on the published data it is believed that the best treatment for trigeminal neurinomas is complete microsurgical removal of the lesion.
从1980年至1993年，对44例三叉神经鞘瘤患者进行了治疗。其中5例因之前在其他地方接受过手术，此次针对残留肿瘤进行手术；35例首次接受手术；4例因各种原因未接受手术。对于起源于半月神经节（GG）外周的第五神经分支的神经鞘瘤，采用硬膜外入路。对于起源于GG或第五神经根的神经鞘瘤，则采用硬膜外-经硬膜或硬膜外-经硬膜-经岩骨入路。所有采用本文所述入路进行手术的肿瘤均被完全切除。10例患者第五神经感觉功能缺损较术前加重；9例患者情况未变；11例患者第五神经感觉功能改善。术前有非典型三叉神经痛的患者，术后疼痛消失。未进行额外治疗：如立体定向放射外科治疗、放疗或化疗。组织病理学检查未发现任何患者的肿瘤有恶性改变。基于我们自己的经验和已发表的数据，认为三叉神经鞘瘤的最佳治疗方法是通过显微手术完全切除病变。
