Surgical management of giant trigeminal schwannomas extending into the parapharyngeal space.
Acta Neurochir (Wien) 2009;
151:335-40. [PMID:
19224122 DOI:
10.1007/s00701-009-0193-9]
[Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Accepted: 01/14/2009] [Indexed: 10/21/2022]
Abstract
PURPOSE
Trigeminal schwannomas extending into the deep parapharyngeal space are relatively rare, and a surgical approach to such tumors has not been well established. We report four cases in which the tumors were completely removed by using a combination of three approaches.
METHODS
Four patients with trigeminal schwannomas extending into the extracranial space were surgically treated using a combination of the transcervical approach, anterolateral retromaxillar pathway via gingivobuccal sulcus, and epi and interdural middle fossa approach.
RESULTS
The maximum diameters of the tumors ranged from 4 to 7 cm. Three tumors extended beyond the lower end of the maxillary sinus. All tumors were completely excised. The Karnofsky performance scales after surgery were more than 90% in all patients.
CONCLUSION
Although the tumors extending to the deep parapharyngeal space are difficult to completely remove via a single approach, a combined approach is useful in these huge extracranial extensions.
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