Document Detail

Greater petrosal nerve schwannomas-analysis of four cases and review of the literature.
MedLine Citation:
PMID:  20668903     Owner:  NLM     Status:  MEDLINE    
Schwannomas arising from the greater petrosal nerve (GPN) are exceedingly rare: only 10 such cases have been reported in the English literature. We report on four cases of GPN schwannomas and discuss the surgical approach for their removal. Four patients with GPN schwannomas underwent surgery at Keio University Hospital. We present the pre- and postoperative clinical findings and describe the structures around the GPN schwannomas as observed during the surgery. Histological sections were performed around the GPN using Masson's trichrome stain to elucidate the membrane structures. Three patients presented with xerophthalmia, and one with facial palsy, hearing disturbance, and generalized convulsions. Contrast-enhanced magnetic resonance images revealed tumors in the temporal lobe. Bone-window computed tomography showed erosion of the anterior petrous apex. During the operation, the temporal lobe was retracted epidurally. The tumors were visible inside the interdural space and covered with the epineurium. In three cases, the tumors were completely removed, and in one case, the tumor was subtotally removed with intraoperative facial monitoring. In the histological sections, we confirmed that the GPN ran within the interdural space. Approaching epi- and interdurally is suitable for the removal of GPN schwannomas because the GPN is located within the interdural space. The advantage of this approach is that the landmark points can be identified. Moreover, the possibility of injuring the temporal lobe is low because the temporal lobe is not exposed in this approach.
Shinya Ichimura; Kazunari Yoshida; Agung Budi Sutiono; Takashi Horiguchi; Hikaru Sasaki; Takeshi Kawase
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Publication Detail:
Type:  Journal Article     Date:  2010-07-29
Journal Detail:
Title:  Neurosurgical review     Volume:  33     ISSN:  1437-2320     ISO Abbreviation:  Neurosurg Rev     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-10     Completed Date:  2011-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7908181     Medline TA:  Neurosurg Rev     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  477-82     Citation Subset:  IM    
Department of Neurosurgery, Keio University, School of Medicine, Shinjukuku, Tokyo, 160-8582, Japan.
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MeSH Terms
Contrast Media
Cranial Nerve Neoplasms / pathology,  surgery*
Facial Nerve / surgery*
Gadolinium DTPA
Magnetic Resonance Imaging
Membranes / pathology
Middle Aged
Neurilemmoma / pathology,  surgery*
Neurosurgical Procedures / methods
Treatment Outcome
Xerophthalmia / etiology
Reg. No./Substance:
0/Contrast Media; 80529-93-7/Gadolinium DTPA

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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