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Operative management of trigeminal schwannomas: based on a modified classification in a study of 93 cases

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Abstract

Background

Advances in microscopic and endoscopic surgical techniques have outpaced traditional classification and transcranial surgical strategies, especially with reference to the treatment of trigeminal schwannomas (TSs). A modified TS classification is proposed and appropriate surgical strategies are discussed.

Methods

The cases of 93 patients who underwent surgical treatment in Beijing Tiantan Hospital in the previous 6 years were analyzed retrospectively, and a literature review was conducted.

Results

Classification is based on surgical direction. Tumors were classified as follows: type A, backward orientation, located in the orbit or orbit and middle cranial fossa (8 cases, 8.6%); type B, upward orientation, located in the pterygopalatine fossa, infratemporal fossa or pterygopalatine fossa, infratemporal fossa, and middle cranial fossa (23 cases, 24.7%); type C, forward and backward orientations, located in the middle cranial fossa, posterior cranial fossa or both (58 cases, 62.4%); and type D, located in multiple regions (4 cases, 4.3%). 91.40% of patients underwent gross total resection (GTR) with 29 cases receiving endoscopic resection of whom 93.10% (27/29) experienced GTR.

Conclusion

The 93 cases were satisfactorily divided into four types, according to tumor location and surgical orientation, enabling safe and effective removal by appropriate surgery.

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Availability of data and material

The data and material are available from the corresponding authors on reasonable request.

Code availability

N/A

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Acknowledgements

The authors sincerely thank all colleagues of the neurosurgery department in Beijing Tiantan Hospital. The authors would like to express their gratitude to EditSprings (https://www.editsprings.cn ) for the expert linguistic services provided.

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Authors and Affiliations

  1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China

    Jie Yin, Zhe Zhang, Yu Zhang, Junhua He, Zhijun Yang, Bo Wang, Xinchao Wang, Gemingtian Liu, Zhixu Bie & Pinan Liu

  2. Department of Neurosurgery, Xuzhou Central Hospital, Xuzhou, People’s Republic of China

    Yihao Wu

  3. Department of Neural Reconstruction, Beijing Key Laboratory of Central Nervous System Injury, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China

    Pinan Liu

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  1. Jie Yin
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Contributions

JY, YW, and YZ were jointly responsible for the analysis of the data and writing of the paper. ZZ and GL participated in the linguistic polishing of the manuscript. JH and ZB helped search the literature, while BW, XW, and ZY were responsible for data collation. PL was responsible for reviewing improvements and financial support.

Corresponding author

Correspondence to Pinan Liu.

Ethics declarations

Ethics approval

This retrospective research obtained approval from the review board of Beijing Tiantan Hospital, Capital Medical University. The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments. Informed consent was obtained from all individual participants (or legal guardians) included in the study.

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The patient gave approval for this publication.

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All authors approved the submission to this journal and publication.

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The authors declare no competing interests.

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Yin, J., Wu, Y., Zhang, Z. et al. Operative management of trigeminal schwannomas: based on a modified classification in a study of 93 cases. Acta Neurochir 165, 4157–4168 (2023). https://doi.org/10.1007/s00701-023-05857-3

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  • DOI: https://doi.org/10.1007/s00701-023-05857-3

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