Vol.:(0123456789) 1 3
Acta Neurochirurgica
https://doi.org/10.1007/s00701-021-05092-8
ORIGINAL ARTICLE - TUMOR - SCHWANNOMA
Management of non‑vestibular schwannomas in adult patients:
a systematic review and consensus statement on behalf of the EANS
skull base section Part II: Trigeminal and facial nerve schwannomas
(CN V, VII)
Jarnail Bal
1
· Michael Bruneau
2
· Moncef Berhouma
3
· Jan F. Cornelius
4
· Luigi M. Cavallo
5
· Roy T. Daniel
6
·
Sebastien Froelich
7
· Emmanuel Jouanneau
8
· Torstein R. Meling
9
· Mahmoud Messerer
6
· Pierre‑Hugues Roche
10
·
Henry W. S. Schroeder
11
· Marcos Tatagiba
12
· Idoya Zazpe
13
· Dimitrios Paraskevopoulos
1
Received: 20 August 2021 / Accepted: 17 December 2021
© The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature 2022
Abstract
Background Non-vestibular schwannomas are relatively rare, with trigeminal and jugular foramen schwannomas being the
most common. This is a heterogenous group which requires detailed investigation and careful consideration to management
strategy. The optimal management for these tumours remains unclear and there are several controversies. The aim of this
paper is to provide insight into the main principles defning management and surgical strategy, in order to formulate a series
of recommendations.
Methods A task force was created by the EANS skull base section committee along with its members and other renowned
experts in the feld to generate recommendations for the surgical management of these tumours on a European perspective.
To achieve this, the task force performed an extensive systematic review in this feld and had discussions within the group.
This article is the second of a three-part series describing non-vestibular schwannomas (V, VII).
Results A summary of literature evidence was proposed after discussion within the EANS skull base section. The constituted
task force dealt with the practice patterns that exist with respect to pre-operative radiological investigations, ophthalmologi-
cal assessments, optimal surgical and radiotherapy strategies, and follow-up management.
Conclusion This article represents the consensually derived opinion of the task force with respect to the treatment of
trigeminal and facial schwannoma. The aim of treatment is maximal safe resection with preservation of function. Careful
thought is required to select the appropriate surgical approach. Most middle fossa trigeminal schwannoma tumours can be
safely accessed by a subtemporal extradural middle fossa approach. The treatment of facial nerve schwannoma remains
controversial.
Keywords Non-vestibular schwannoma · Radiosurgery · Trigeminal schwannoma · Facial nerve schwannoma · Quality of
life
Introduction
The description of a schwannoma was frst by Verocay in
1910 [34, 80]. These tumours originate from Schwann cells,
with the majority arising from the cranial nerves. Predomi-
nately tumours originate on the sensory nerves, but there is
an association with tumours that arise from motor nerves
with neurofbromatosis (NF) [70, 72].
For the non-vestibular schwannoma cohort, trigeminal
schwannomas are the most common representing between
0.8 and 8% of schwannomas [38], followed by jugular
This article is part of the Topical Collection on Tumor—
Schwannoma
* Dimitrios Paraskevopoulos
d.paraskevopoulos@nhs.net
Extended author information available on the last page of the article