J Korean Neurosurg Soc.
2010 Oct;48(4):383-387.
Surgery for a Case of Three-Compartment Trigeminal Schwannoma : Technical Aspects
- Affiliations
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- 1Department of Neurosurgery, Eulji University Hospital, Daejeon, Korea. neurocsy@eulji.ac.kr
Abstract
- Complete removal of three-compartment trigeminal schwannomas is a challenge to neurosurgeons. To expand exposure of each compartment, the combination and modification of skull base approaches are necessary. The 61-year-old woman was admitted with chronic headache. Preoperative magnetic resonance imaging showed 47x50x40 mm-sized tumor originating primarily in the middle cranial fossa extended to the posterior and the infratemporal fossa. We performed operation in five stage; 1. Zygomatic osteotomy, 2. Inferior temporal fossa plate removal and foramen ovale opening, 3. Cavernous sinus opening, 4. Tailored anterior petrosectomy, 5. Meckel's cave opening. Combination of skull base surgery should be concerned according to the patient. In this study, extradural basal extension with zygomatic osteotomy, interdural posterior extension with tailored anterior petrosectomy, and intracavernous exploration are reasonable options for remodeling three-compartment lesion into a single compartment. Tailoring of bone resection and exploring through natural pathway between meningeal layers accomplish single-stage operation for complete removal of tumors.
MeSH Terms
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Antineoplastic Combined Chemotherapy Protocols
Cavernous Sinus
Cranial Fossa, Middle
Cyclophosphamide
Doxorubicin
Female
Foramen Ovale
Headache Disorders
Humans
Magnetic Resonance Imaging
Middle Aged
Neurilemmoma
Osteotomy
Podophyllotoxin
Skull Base
Vincristine
Antineoplastic Combined Chemotherapy Protocols
Cyclophosphamide
Doxorubicin
Podophyllotoxin
Vincristine
