Greater petrosal nerve schwannomas-analysis of four cases and review of the literature

Shinya Ichimura, Kazunari Yoshida, Agung Budi Sutiono, Takashi Horiguchi, Hikaru Sasaki, Takeshi Kawase

研究成果: Article査読

23 被引用数 (Scopus)

抄録

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 During the operation, the temporal lobe was retracted epidurally.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.

本文言語English
ページ(範囲)477-482
ページ数6
ジャーナルNeurosurgical Review
33
4
DOI
出版ステータスPublished - 2010 10月 1

ASJC Scopus subject areas

  • 外科
  • 臨床神経学

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