{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T12:51:29Z","timestamp":1783774289524,"version":"3.55.0"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2014,10]]},"abstract":"\n Object<\/jats:title>\n Because multiple anatomical compartments are involved, the surgical management of trigeminal schwannomas requires a spectrum of cranial base approaches. The endoscopic endonasal approach to Meckel's cave provides a minimal access corridor for surgery, but few reports have assessed outcomes of the procedure or provided guidelines for case selection.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A prospectively acquired database of 680 endoscopic endonasal cases was queried for trigeminal schwannoma cases. Clinical charts, radiographic images, and long-term outcomes were reviewed to determine outcome and success in removing tumor from each compartment traversed by the trigeminal nerve.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Four patients had undergone endoscopic resection of trigeminal schwannomas via the transpterygoid approach (mean follow-up 37 months). All patients had disease within Meckel's cave, and 1 patient had extension into the posterior fossa. Gross-total resection was achieved in 3 patients whose tumors were purely extracranial. One patient with combined Meckel's cave and posterior fossa tumor had complete resection of the extracranial disease and 52% resection of the posterior fossa disease. One patient with posterior fossa disease experienced a sixth cranial nerve palsy in addition to a corneal keratopathy from worsened trigeminal neuropathy. There were no CSF leaks. Over the course of the study, 1 patient with subtotal resection required subsequent stereotactic radiosurgery for disease progression within the posterior fossa.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Endoscopic endonasal approaches appear to be well suited for trigeminal schwannomas restricted to Meckel's cave and\/or extracranial segments of the nerve. Lateral transcranial skull base approaches should be considered for patients with posterior fossa disease. Further multiinstitutional studies will be necessary for adequate power to help determine relative indications between endoscopic and transcranial skull base approaches.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2014.7.focus14341","type":"journal-article","created":{"date-parts":[[2014,10,1]],"date-time":"2014-10-01T04:43:47Z","timestamp":1412138627000},"page":"E17","source":"Crossref","is-referenced-by-count":67,"title":["Surgical management of trigeminal schwannomas: defining the role for endoscopic endonasal approaches"],"prefix":"10.3171","volume":"37","author":[{"given":"Shaan M.","family":"Raza","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela M.","family":"Donaldson","sequence":"additional","affiliation":[{"name":"Otolaryngology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alpesh","family":"Mehta","sequence":"additional","affiliation":[{"name":"Neuroradiology, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apostolos J.","family":"Tsiouris","sequence":"additional","affiliation":[{"name":"Neuroradiology, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay K.","family":"Anand","sequence":"additional","affiliation":[{"name":"Otolaryngology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore H.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Otolaryngology,"},{"name":"Neuroscience, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus14341","series-title":"J Neurosurg","first-page":"453","article-title":"Trigeminal schwannomas: removal of dumbbell-shaped tumors through the expanded Meckel cave and outcomes of cranial nerve function","volume":"96","author":"Al-Mefty","year":"2002"},{"key":"b2-focus14341","series-title":"Neurosurgery","first-page":"144","article-title":"Avoiding injury to the abducens nerve during expanded endonasal endoscopic surgery: anatomic and clinical case studies","volume":"67","author":"Barges-Coll","year":"2010"},{"key":"b3-focus14341","series-title":"Neurosurgery","first-page":"233","article-title":"The surgical management of trigeminal neuromas","volume":"42","author":"Day","year":"1998"},{"key":"b4-focus14341","series-title":"Acta Neurochir (Wien)","first-page":"55","article-title":"Frontotemporal epidural approach to trigeminal neurinomas","volume":"130","author":"Dolenc","year":"1994"},{"key":"b5-focus14341","series-title":"Neurosurgery","first-page":"783","article-title":"Trigeminal neuroma: analysis of surgical experience with 73 cases","volume":"52","author":"Goel","year":"2003"},{"key":"b6-focus14341","series-title":"Laryngoscope","first-page":"195","article-title":"Evolution in the assessment and management of trigeminal schwannoma","volume":"118","author":"Guthikonda","year":"2008"},{"key":"b7-focus14341","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1115","article-title":"Long-term results for trigeminal schwannomas treated with gamma knife surgery","volume":"87","author":"Hasegawa","year":"2013"},{"key":"b8-focus14341","series-title":"J Neurosurg","first-page":"967","article-title":"The endoscopic, endonasal, transmaxillary transpterygoid approach to the pterygopalatine fossa, infratemporal fossa, petrous apex, and the Meckel cave. Clinical article","volume":"113","author":"Hofstetter","year":"2010"},{"key":"b9-focus14341","series-title":"Skull Base","first-page":"357","article-title":"Microsurgical anatomy of the cavernous sinus: measurements of the triangles in and around it","volume":"17","author":"Isolan","year":"2007"},{"issue":"3 Suppl","key":"b10-focus14341","series-title":"Neurosurgery","first-page":"ons71","article-title":"The front door to Meckel's cave: an anteromedial corridor via expanded endoscopic endonasal approach\u2014technical considerations and clinical series","volume":"64","author":"Kassam","year":"2009"},{"key":"b11-focus14341","series-title":"Acta Neurochir (Wien)","first-page":"118","article-title":"Neurinomas of the trigeminal nerve","volume":"82","author":"Lesoin","year":"1986"},{"key":"b12-focus14341","series-title":"World Neurosurg","first-page":"136","article-title":"Long-term effectiveness of a reconstructive protocol using the nasoseptal flap after endoscopic skull base surgery","volume":"81","author":"McCoul","year":"2014"},{"key":"b13-focus14341","series-title":"Otolaryngol Head Neck Surg","first-page":"327","article-title":"Janus flap: bilateral nasoseptal flaps for anterior skull base reconstruction","volume":"142","author":"Nyquist","year":"2010"},{"key":"b14-focus14341","series-title":"J Neurosurg","first-page":"661","article-title":"Case-specific protocol to reduce cerebrospinal fluid leakage after endonasal endoscopic surgery. Clinical article","volume":"119","author":"Patel","year":"2013"},{"key":"b15-focus14341","series-title":"J Neurosurg","first-page":"737","article-title":"Neurilemomas of the trigeminal nerve","volume":"70","author":"Pollack","year":"1989"},{"key":"b16-focus14341","series-title":"Neurosurgery","first-page":"1116","article-title":"Three-dimensional and 2-dimensional endoscopic exposure of midline cranial base targets using expanded en donasal and transcranial approaches","volume":"65","author":"Roth","year":"2009"},{"key":"b17-focus14341","series-title":"J Neurosurg","first-page":"711","article-title":"Surgical treatment of trigeminal schwannomas","volume":"82","author":"Samii","year":"1995"},{"key":"b18-focus14341","series-title":"Neurosurgery","first-page":"1046","article-title":"Endoscopic endonasal approach for nonvestibular schwannomas","volume":"69","author":"Shin","year":"2011"},{"key":"b19-focus14341","series-title":"J Neurosurg","first-page":"719","article-title":"Comparison of conventional and skull base surgical approaches for the excision of trigeminal neurinomas","volume":"82","author":"Taha","year":"1995"},{"key":"b20-focus14341","series-title":"Eur Arch Otorhinolaryngol","first-page":"787","article-title":"Meckel's cave access: anatomic study comparing the endoscopic transantral and endonasal approaches","volume":"271","author":"Van Rompaey","year":"2014"},{"issue":"1 Suppl Operative","key":"b21-focus14341","series-title":"Neurosurgery","first-page":"132","article-title":"Trigeminal schwannomas: skull base approaches and operative results in 105 patients","volume":"70","author":"Wanibuchi","year":"2012"},{"key":"b22-focus14341","series-title":"J Neurosurg","first-page":"202","article-title":"Trigeminal neurinomas extending into multiple fossae: surgical methods and review of the literature","volume":"91","author":"Yoshida","year":"1999"},{"key":"b1-focus14341","series-title":"J Neurosurg","first-page":"453","article-title":"Trigeminal schwannomas: removal of dumbbell-shaped tumors through the expanded Meckel cave and outcomes of cranial nerve function","volume":"96","author":"Al-Mefty","year":"2002"},{"key":"b2-focus14341","series-title":"Neurosurgery","first-page":"144","article-title":"Avoiding injury to the abducens nerve during expanded endonasal endoscopic surgery: anatomic and clinical case studies","volume":"67","author":"Barges-Coll","year":"2010"},{"key":"b3-focus14341","series-title":"Neurosurgery","first-page":"233","article-title":"The surgical management of trigeminal neuromas","volume":"42","author":"Day","year":"1998"},{"key":"b4-focus14341","series-title":"Acta Neurochir (Wien)","first-page":"55","article-title":"Frontotemporal epidural approach to trigeminal neurinomas","volume":"130","author":"Dolenc","year":"1994"},{"key":"b5-focus14341","series-title":"Neurosurgery","first-page":"783","article-title":"Trigeminal neuroma: analysis of surgical experience with 73 cases","volume":"52","author":"Goel","year":"2003"},{"key":"b6-focus14341","series-title":"Laryngoscope","first-page":"195","article-title":"Evolution in the assessment and management of trigeminal schwannoma","volume":"118","author":"Guthikonda","year":"2008"},{"key":"b7-focus14341","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1115","article-title":"Long-term results for trigeminal schwannomas treated with gamma knife surgery","volume":"87","author":"Hasegawa","year":"2013"},{"key":"b8-focus14341","series-title":"J Neurosurg","first-page":"967","article-title":"The endoscopic, endonasal, transmaxillary transpterygoid approach to the pterygopalatine fossa, infratemporal fossa, petrous apex, and the Meckel cave. Clinical article","volume":"113","author":"Hofstetter","year":"2010"},{"key":"b9-focus14341","series-title":"Skull Base","first-page":"357","article-title":"Microsurgical anatomy of the cavernous sinus: measurements of the triangles in and around it","volume":"17","author":"Isolan","year":"2007"},{"issue":"3 Suppl","key":"b10-focus14341","series-title":"Neurosurgery","first-page":"ons71","article-title":"The front door to Meckel's cave: an anteromedial corridor via expanded endoscopic endonasal approach\u2014technical considerations and clinical series","volume":"64","author":"Kassam","year":"2009"},{"key":"b11-focus14341","series-title":"Acta Neurochir (Wien)","first-page":"118","article-title":"Neurinomas of the trigeminal nerve","volume":"82","author":"Lesoin","year":"1986"},{"key":"b12-focus14341","series-title":"World Neurosurg","first-page":"136","article-title":"Long-term effectiveness of a reconstructive protocol using the nasoseptal flap after endoscopic skull base surgery","volume":"81","author":"McCoul","year":"2014"},{"key":"b13-focus14341","series-title":"Otolaryngol Head Neck Surg","first-page":"327","article-title":"Janus flap: bilateral nasoseptal flaps for anterior skull base reconstruction","volume":"142","author":"Nyquist","year":"2010"},{"key":"b14-focus14341","series-title":"J Neurosurg","first-page":"661","article-title":"Case-specific protocol to reduce cerebrospinal fluid leakage after endonasal endoscopic surgery. Clinical article","volume":"119","author":"Patel","year":"2013"},{"key":"b15-focus14341","series-title":"J Neurosurg","first-page":"737","article-title":"Neurilemomas of the trigeminal nerve","volume":"70","author":"Pollack","year":"1989"},{"key":"b16-focus14341","series-title":"Neurosurgery","first-page":"1116","article-title":"Three-dimensional and 2-dimensional endoscopic exposure of midline cranial base targets using expanded en donasal and transcranial approaches","volume":"65","author":"Roth","year":"2009"},{"key":"b17-focus14341","series-title":"J Neurosurg","first-page":"711","article-title":"Surgical treatment of trigeminal schwannomas","volume":"82","author":"Samii","year":"1995"},{"key":"b18-focus14341","series-title":"Neurosurgery","first-page":"1046","article-title":"Endoscopic endonasal approach for nonvestibular schwannomas","volume":"69","author":"Shin","year":"2011"},{"key":"b19-focus14341","series-title":"J Neurosurg","first-page":"719","article-title":"Comparison of conventional and skull base surgical approaches for the excision of trigeminal neurinomas","volume":"82","author":"Taha","year":"1995"},{"key":"b20-focus14341","series-title":"Eur Arch Otorhinolaryngol","first-page":"787","article-title":"Meckel's cave access: anatomic study comparing the endoscopic transantral and endonasal approaches","volume":"271","author":"Van Rompaey","year":"2014"},{"issue":"1 Suppl Operative","key":"b21-focus14341","series-title":"Neurosurgery","first-page":"132","article-title":"Trigeminal schwannomas: skull base approaches and operative results in 105 patients","volume":"70","author":"Wanibuchi","year":"2012"},{"key":"b22-focus14341","series-title":"J Neurosurg","first-page":"202","article-title":"Trigeminal neurinomas extending into multiple fossae: surgical methods and review of the literature","volume":"91","author":"Yoshida","year":"1999"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/37\/4\/article-pE17.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/37\/4\/article-pE17.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/37\/4\/article-pE17.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T08:42:00Z","timestamp":1780130520000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/37\/4\/article-pE17.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10]]},"references-count":44,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2014.7.focus14341","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,10]]}}}