• Masahiko Wanibuchi, Takanori Fukushima, Ali R Zomordi, Yoichi Nonaka, and Allan H Friedman.
• Department of Neurosurgery, Sapporo Medical University School of Medicine, Hokkaido, Japan. wanibuti@sapmed.ac.jp
• Neurosurgery. 2012 Mar 1;70(1 Suppl Operative):132-43; discussion 143-4.

BackgroundTrigeminal schwannomas make up 0.8% to 8% of all intracranial schwannomas.ObjectiveTo analyze our surgical experience with trigeminal schwannomas.MethodsWe performed 107 operations on 105 patients harboring trigeminal schwannomas over the past 30 years. We classified the tumors as peripheral, ganglion cavernous, posterior fossa root, and dumbbell types according to the portion of the nerve that gave rise to the tumor.ResultsFourteen were peripheral-type tumors (13.1%), 39 (36.4%) were ganglion cavernous type, 22 (20.6%) were posterior fossa root type, and 32 (30.0%) were dumbbell type. Sixty-five tumors were solid, 35 were mixed, and only 7 were cystic. Among solid tumors, 14 were vascular, fibrous, and adherent to adjacent structures. Total or near-total removal was performed in 86 cases (81.9%), and subtotal removal was achieved in 18 (17.1%). The most common symptom was facial hypesthesia, occurring in 69 patients. This symptom improved in 11 patients, persisted in 50 patients, and worsened in 8 patients after surgery. New postoperative hypesthesia was observed in 8 patients. The second most common symptom was facial pain, observed in 24 patients. Facial pain subsided in 22 and persisted in 2 patients after surgery. Diplopia was observed in 21 patients. This symptom improved postoperatively in 14 patients, persisted in 6 patients, and worsened in 1 patient.ConclusionThe present series demonstrates acceptable results using microsurgical treatment to remove trigeminal schwannomas. Pain and diplopia may be relieved after surgery; however, hypesthesia frequently remains or may be worsened by surgery.

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