Skull base surgery of non vestibular schwannomas of the posterior cranial fossa

Abstract

Objective: To study the surgical approaches and results of surgery in twenty one patients with non vestibular schwannomas operated upon at the neurosurgery department Methods: We retrospectively analyzed a series of 21 patients with histologically verified non-vestibular schwannomas, treated at the Neurosurgery Department, Alexandria University in the period between 2003 and 2008. The age in this group of patients ranged from 20 to 65 years (Mean 38 years). All patients underwent detailed general and neurological examination and preoperative gadolinium-enhanced magnetic resonance imaging (MRI). Computerized tomography (CT) scan with thin slices was used in 16 cases to study the bony anatomy. The mean follow-up period was 29 months (range 10 to 61 months). Results: Twenty one patients with intracranial schwannomas arising from cranial nerves other than the vestibulocochlear were surgically treated in the Neurosurgery department, Alexandria University, in the period between 2003 and 2008. There were 14 males and 7 females and the mean age was 38 years. Seven of our patients underwent surgery elsewhere for partial resection before being referred to our facility; one of these cases underwent fractionated stereotactic radiotherapy for residual tumor after the first surgical intervention. Conclusion: Non-vestibular schwannomas are rare tumors that are best treated by total surgical resection. The location and size of the tumor dictates the surgical approach, however skull base approaches offer better tumor exposure and therefore result in better total tumor resection rate. Key words: Skull base, schwannomas, surgical approaches.