Clinical Study Trigeminal schwannomas: Experience with 68 cases Bhawani Shankar Sharma * , Faiz Uddin Ahmad, Poodipedi Sarat Chandra, Ashok Kumar Mahapatra Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi 110 029, India Received 19 June 2006; accepted 8 September 2006 Abstract Trigeminal schwannomas (TS) are rare. Only a couple of series involving a large number of cases have been reported. In the present study we aimed to analyse the clinical characteristics of TS, the surgical approaches used to treat TS, and the outcomes for patients undergoing surgical treatment for TS via retrospective analysis of departmental records. Data for 68 patients treated for TS in the Department of Neurosurgery at the All India Institute of Medical Sciences between January 1993 and December 2005 were analysed. Most patients were in the fourth decade of life, with the duration of symptoms ranging from 1 month to 13 years. Twenty-nine TSs were classified as type A, 13 as type B and 26 as type C, depending upon size. A skull base approach was used in every surgically treated case. Of the 46 patients for whom radiological follow-up data were available, complete tumour excision was achieved in 35 cases (76%). Fol- low-up ranged from 3 months to 12 years (mean 62 months). One patient died and nine (15%) had permanent morbidity in the form of corneal opacity (5) or facial (2) or trochlear (2) nerve palsy. We conclude that trigeminal neuromas are best treated by total surgical resection, which yields acceptable results with low rates of mortality and permanent morbidity. Ó 2007 Elsevier Ltd. All rights reserved. Keywords: Trigeminal schwannoma; Management; Outcome 1. Introduction Schwannomas arising from the trigeminal nerve are rare, constituting only 0.1–0.4% of all intracranial tumours and 1–8% of all intracranial schwannomas. 1–10 Only a cou- ple of large case series of trigeminal schwannoma (TS) have been reported in the literature. 1–3 The surgical approach that is most appropriate for these tumours remains contro- versial. We report our experience of 68 of these tumours. 2. Subjects and methods Between January 1993 and December 2005, 68 patients were treated for TS in the Department of Neurosurgery at the All India Institute of Medical Sciences, New Delhi. Data were retrospectively collected from the hospital re- cords and analysed. 2.1. Patient population Of 68 patients, 46 were male and 22 were female (ratio of 2:1). The ages of the patients ranged from 16 to 62 years, with a mean of 38 years. The left side (41 patients [60%]) was involved more commonly than the right (27 patients [40%]). Most patients were young to middle-aged, with the largest number of patients in the fourth decade of life. The duration of symptoms ranged from 1 month to 13 years. Facial pain and paraesthesias were the most com- mon presenting symptoms, being present in 62 cases (91%). After the trigeminal nerve, the seventh cranial nerve was the next most commonly involved nerve (24 cases; 35%). Other cranial nerves were also commonly involved. Notably, the lower cranial nerves were involved in 17 cases. Raised intracranial pressure (ICP) was present in 35 pa- tients (51%). Five patients presented with altered senso- rium (Table 1). Either CT or MRI was carried out for 26 patients, and 42 patients underwent both CT and MRI. 0967-5868/$ - see front matter Ó 2007 Elsevier Ltd. All rights reserved. doi:10.1016/j.jocn.2006.09.007 * Corresponding author. Tel.: +91 11 26584573. E-mail address: drsharmabs@yahoo.com (B.S. Sharma). www.elsevier.com/locate/jocn Available online at www.sciencedirect.com Journal of Clinical Neuroscience 15 (2008) 738–743