Single-stage removal of a neurinoma of the trigeminal nerve, localized in the posterior, middle cranial and infratemporal fossae. Clinical observation and review of literature

Abstract

Background. In the course of the analysis of available foreign and domestic literature, 65 observations of trigeminal tumors with extracranial growth were found, the total removal of which was performed only in 20% of patients. The aim of the study is to show the potential of skull base tumor surgery using an example of a successful surgical treatment of a patient with a spread trigeminal neurinoma located in the posterior, middle and infratemporal fossae, as well as to analyze the international scientific experience on this issue. Clinical case description. A 60-year-old patient with a spread trigeminal neurinoma on the left was admitted to the Federal Scientific-Clinical Center of FMBA of Russia in February 2020. After an additional examination and preoperative preparation, a planned operation was performed osteoplastic orbitozygomatic craniotomy, a microsurgical removal of the tumor through the subtemporal transcavernous approach. A good postoperative clinical result was obtained. An analysis of the available scientific literature on this problem has been performed. In the postoperative period, pain and neurological symptoms, hemifacial spasm completely regressed. 1.5 months after the operation, the tumor was shown to be totally removed by the control images. Conclusion. Despite the extreme complexity of the pathology, the operation via the orbitozygomatic subtemporal transcavernous approach allows one to completely remove common and giant trigeminal neurinomas with a good functional result.

Keywords

• trigeminal neurinoma
• middle
• posterior and infratemporal fossae
• hemifacial spasm