Sphenocavernous and infratemporal trigeminal neurinomas: surgical series of 15 cases.

A consecutive series of 15 patients with trigeminal schwannomas treated surgically at the Centre Medico-Chirurgical Foch between 1979 and 1985 is reported. This report is limited to sphenocavernous (nine cases) and infratemporal (six cases) tumors. Initial clinical symptoms of these cases are detailed, including trigeminal and abducens nerve signs. Preoperative selective angiography and embolization are important adjuncts to surgical management. The surgical approach depends on the anatomic location of the tumor. Sphenocavernous neurinomas were removed through a pterionosubtemporal approach. Occasionally, infratemporal neurinomas were approached in two stages because of the need to reconstruct the skull base and prevent postoperative cerebrospinal fluid rhinorrhea. There were no operative deaths in the series and complete extirpation was achieved in all but one case.