Abstract
We retrospectively reviewed records of 33 consecutive trigeminal schwannoma patients who underwent Gamma Knife® SRS. Two patients had neurofibromatosis type 2. The median patient age was 49 years (range, 15–82 years). Eleven patients had prior surgical resection of their tumors. The tumors were classified into root type (N = 6), ganglion type (N = 17) and dumbbell type (N = 10) based on their location. The median tumor volume was 4.2 cc (range, 0.5–18.0 cc) and the median marginal dose was 15.0 Gy (range, 12–20 Gy). At an average of 6 years (range, 7.2–147.9 months), the progression free survival after SRS at 1-, 5- and 10 years, respectively was 97%, 82% and 82%. Factors associated with an improved progression free survival included female gender, smaller tumor volume, and root or ganglion type tumors. Neurological symptoms or signs improved in 11 of 33 patients (33%) and unchanged in 19 patients (58%). Three patients (9%) had symptomatic progression. Patients without prior resection were significantly more likely to have improvement in neurological symptoms or signs. Predictors of better response included female gender, smaller volume, root and ganglion type tumors, and use of SRS as the primary management.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Al-Mefty O, Ayoubi S, Gaber E (2002) Trigeminal schwannomas: removal of dumbbell-shaped tumors through the expanded Meckel cave and outcomes of cranial nerve function. J Neurosurg 96:453–463
Andrews DW, Suarez O, Goldman HW, Downes MB, Bednarz G, Corn BW, Werner-Wasik M, Rosenstock J, Curran WJ Jr (2001) Stereotactic radiosurgery and fractionated stereotactic radiotherapy for the treatment of acoustic schwannomas: comparative observations of 125 patients treated at one institution. Int J Radiat Oncol Biol Phys 50:1265–1278
Day JD, Fukushima T (1998) The surgical management of trigeminal neuromas. Neurosurgery 42:233–240; discussion 240–231
de Benedittis G, Bernasconi V, Ettorre G (1977) Tumours of the fifth cranial nerve. Acta Neurochir (Wien) 38:37–64
Eisenberg MB, Al-Mefty O, DeMonte F, Burson GT (1999) Benign nonmeningeal tumors of the cavernous sinus. Neurosurgery 44:949–954; discussion 954–945
Flickinger JC, Kondziolka D, Pollock BE, Lunsford LD (1996) Evolution in technique for vestibular schwannoma radiosurgery and effect on outcome. Int J Radiat Oncol Biol Phys 36:275–280
Flickinger JC, Kondziolka D, Niranjan A, Lunsford LD (2001) Results of acoustic neuroma radiosurgery: an analysis of 5 years’ experience using current methods [see comment]. J Neurosurg 94:1–6
Goel A, Muzumdar D, Raman C (2003) Trigeminal neuroma: analysis of surgical experience with 73 cases. Neurosurgery 52:783–790; discussion 790
Hasegawa T, Kida Y, Yoshimoto M, Koike J (2007) Trigeminal schwannomas: results of gamma knife surgery in 37 cases. J Neurosurg 106:18–23
Kano H, Niranjan A, Kondziolka D, Flickinger JC, Dade Lunsford L (2009) Stereotactic radiosurgery for trigeminal schwannoma: tumor control and functional preservation Clinical article. J Neurosurg 110:553–558
Konovalov AN, Spallone A, Mukhamedjanov DJ, Tcherekajev VA, Makhmudov UB (1996) Trigeminal neurinomas. A series of 111 surgical cases from a single institution. Acta Neurochir (Wien) 138:1027–1035
McCormick PC, Bello JA, Post KD (1988) Trigeminal schwannoma. Surgical series of 14 cases with review of the literature. J Neurosurg 69:850–860
Niranjan A, Lunsford LD, Flickinger JC, Maitz A, Kondziolka D (1999) Dose reduction improves hearing preservation rates after intracanalicular acoustic tumor radiosurgery. Neurosurgery 45:753–762; discussion 762–755
Pan L, Wang EM, Zhang N, Zhou LF, Wang BJ, Dong YF, Dai JZ, Cai PW (2005) Long-term results of Leksell gamma knife surgery for trigeminal schwannomas. J Neurosurg 102(Suppl):220–224
Pollack IF, Sekhar LN, Jannetta PJ, Janecka IP (1989) Neurilemomas of the trigeminal nerve. J Neurosurg 70:737–745
Pollock BE, Foote RL, Stafford SL (2002) Stereotactic radiosurgery: the preferred management for patients with nonvestibular schwannomas? Int J Radiat Oncol Biol Phys 52:1002–1007
Regis J, Pellet W, Delsanti C, Dufour H, Roche PH, Thomassin JM, Zanaret M, Peragut JC (2002) Functional outcome after gamma knife surgery or microsurgery for vestibular schwannomas. J Neurosurg 97:1091–1100
Samii M, Babu RP, Tatagiba M, Sepehrnia A (1995a) Surgical treatment of jugular foramen schwannomas. J Neurosurg 82:924–932
Samii M, Migliori MM, Tatagiba M, Babu R (1995b) Surgical treatment of trigeminal schwannomas. J Neurosurg 82:711–718
Sarma S, Sekhar LN, Schessel DA (2002) Nonvestibular schwannomas of the brain: a 7-year experience. Neurosurgery 50:437–448; discussion 438–439
Sheehan J, Yen CP, Arkha Y, Schlesinger D, Steiner L (2007) Gamma knife surgery for trigeminal schwannoma. J Neurosurg 106:839–845
Suh JH, Barnett GH, Sohn JW, Kupelian PA, Cohen BH (2000) Results of linear accelerator-based stereotactic radiosurgery for recurrent and newly diagnosed acoustic neuromas. Int J Cancer 90:145–151
Taha JM, Tew JM Jr, van Loveren HR, Keller JT, el-Kalliny M (1995) Comparison of conventional and skull base surgical approaches for the excision of trigeminal neurinomas. J Neurosurg 82:719–725
Yasui T, Hakuba A, Kim SH, Nishimura S (1989) Trigeminal neurinomas: operative approach in eight cases. J Neurosurg 71:506–511
Yoshida K, Kawase T (1999) Trigeminal neurinomas extending into multiple fossae: surgical methods and review of the literature. J Neurosurg 91:202–211
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Science+Business Media B.V.
About this chapter
Cite this chapter
Kano, H., Kondziolka, D., Niranjan, A., Flickinger, J.C., Lunsford, L.D. (2012). Stereotactic Radiosurgery for Trigeminal Schwannoma: Tumor Control and Functional Preservation. In: Hayat, M. (eds) Tumors of the Central Nervous System, Volume 7. Tumors of the Central Nervous System, vol 7. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2894-3_30
Download citation
DOI: https://doi.org/10.1007/978-94-007-2894-3_30
Published:
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-007-2893-6
Online ISBN: 978-94-007-2894-3
eBook Packages: MedicineMedicine (R0)