Surgical treatment of trigeminal neurinomas

Objective To investigate the best surgical approach for the removal of trigeminal neurinomas (TNs). Methods A retrospective analysis of 75 patients with TNs in Huashan Hospital was carried out. Results In the early group (1978-1984), a series of conventional intradural approaches were used; in the late group (1985-1995), an epidural approach via the skull base craniotomy was used. Total tumor removal was achieved in 58% (20/35) of patients in the early group and 80% (32/40) in the late group (P<0.025). Temporary and permanent cranial nerve morbidity were 62.7% and 37% in the early group and 28.1% and 10% in the late group (P<0.001). Conclusion The best microsurgical approach for the removal of trigeminal neurinomas except those confined to the posterior fossa is epidural approach or epiduro transduro transtentorial approach via the skull base craniotomy.