Endoscopic endonasal approach for trigeminal schwannomas: our experience of 39 patients in 10 years
| Autor: | Dehui Wang, Lu Yang, Weidong Zhao, Li Hu, Quan Liu, Huankang Zhang |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Weakness Endoscope Tumor resection Skull Neoplasms Nose 03 medical and health sciences 0302 clinical medicine Postoperative Complications medicine Maxilla Humans Pterygopalatine fossa Aged Retrospective Studies medicine.diagnostic_test business.industry Infratemporal fossa Endoscopy General Medicine Middle Aged Surgery medicine.anatomical_structure Otorhinolaryngology 030220 oncology & carcinogenesis Female Neurosurgery medicine.symptom business 030217 neurology & neurosurgery Neurilemmoma |
| Zdroj: | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 275(3) |
| ISSN: | 1434-4726 |
| Popis: | The anatomical locations involved in trigeminal schwannomas (TSs) are quite complex. The endoscopic endonasal approach provides a minimal damage access corridor to both anterior and middle skull base for surgery. Given the nerve function recovery and postoperative neurological deterioration varied in different reports, the author demonstrates his surgery tips and the functional outcomes under endoscopic surgery in one single institution. A retrospective review of patients with TSs was undertaken to assess the outcome of endoscopic surgery from 2006 to 2016. Clinical features, imaging findings, preoperative/postoperative neurological deficits, surgical approaches and followed up data were collected. Thirty-nine patients with TSs were included in this study. Surgical approaches include endoscopic medial maxillectomy approach (n = 8), endoscopic endonasal-assisted sublabial transmaxillary approach (n = 27) and endoscopic endonasal-assisted sublabial transmaxillary combined with septectomy (n = 4). Gross total resection and sub-total resection were achieved in 27 and 10 patients, respectively. The most common chief complaint was facial numbness, accounting for 41%, with a resolved rate of 62.5% after treatment. Fifteen patients developed new neurologic symptoms, including facial numbness/pain (n = 9 and 2, respectively), dry eye (n = 3) and mastication weakness (n = 1). Eight of these patients had partial improvement except for patients with dry eye. Endoscopic endonasal approach represents a safe and effective surgical procedure for TSs in pterygopalatine fossa, infratemporal fossa and even Meckel cave. Tumor resection can be achieved by endoscope with few neurologic deficits and complications. |
| Databáze: | OpenAIRE |
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