• Baris Ozoner, Abuzer Gungor, Hatice Ture, and Ugur Ture.
• Department of Neurosurgery, Kartal Dr. Lutfi Kirdar Research and Education Hospital, Istanbul, Turkey; Department of Neurosurgery, Yeditepe University School of Medicine, Istanbul, Turkey.
• World Neurosurg. 2022 Jun 1; 162: e288e300e288-e300.

Background And ObjectiveCranial nerve schwannomas almost always arise from sensory or mixed nerves. Motor cranial nerves, such as the trochlear nerve, are rarely associated with schwannomas. No consensus has yet been made for surgical intervention because of the low number of reported cases of trochlear nerve schwannomas. This study comprises a systematic review of the literature and our experience for surgically treated trochlear nerve schwannomas.MethodsThree databases (Web of Science, PubMed, and Cochrane Library) were searched without date restrictions. Studies were included if they were published in the English literature and presented patients of any age who underwent surgical treatment for trochlear schwannoma. Data extracted from the included studies were combined with our experience.ResultsForty-one studies, presenting 43 patients, met the inclusion criteria. The total number of patients was 45 after our experience was added. The most common symptoms were diplopia (62.2%), headache (46.7%), and motor weakness (37.8%). Mean age during the diagnosis was 45.1 years. Although the subtemporal transtentorial approach (n = 14) is the most preferred method, its application has decreased in recent years. In the last decade, the lateral suboccipital approach (n = 11) has gained popularity. Residual postoperative trochlear nerve deficit was detected in 81% of patients. The probability of neurologic deficit was not statistically associated with tumor volume (P = 0.914), location (P = 0.669), or resection rate (P = 0.554).ConclusionsAlthough trochlear schwannomas are rare and their treatment involves challenges, total resection with the proper approach provides the most desirable results.Copyright © 2022 Elsevier Inc. All rights reserved.

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