Trigeminal @entity808 : removal of dumbbell-shaped @entity5 through the expanded Meckel cave and outcomes of XXXX .

@entity1 @entity129 @entity5513 @entity808 @entity5 @entity21591 @entity158 @entity2359
OBJECT: As in @entity1 with @entity5513 , advances in surgical procedures have markedly improved outcomes in @entity1 with trigeminal @entity808 . In this article the authors address the function of cranial nerves in a series of @entity1 with trigeminal @entity808 that were treated with gross-total surgical removal. The authors emphasize a technique they use to remove a dumbbell-shaped @entity5 through the expanded Meckel cave, and discuss the advantage of the extradural zygomatic middle fossa approach for total @entity5 and preservation or improvement of @entity129 . METHODS: Within an 11-year period (1989-2000), 25 @entity1 (14 female and 11 male @entity1 with a mean age of 44.4 years) with benign trigeminal @entity808 were surgically treated by the senior author (O.A.) with the aim of total @entity5 . Three @entity1 had undergone previous surgery elsewhere. @entity21591 was present in all but two @entity1 . Abducent nerve paresis was present in 40%. The approach in each @entity1 was selected according to the location and size of the lesion. @entity5 were dumbbell shaped and extended into both middle and posterior fossae. All 25 @entity5 involved the cavernous sinus. The zygomatic middle fossa approach was particularly useful and was used in 14 @entity1 . The mean follow-up period was 33.12 months. In @entity1 who had not undergone previous surgery, the preoperative trigeminal sensory deficit improved in 44%, facial @entity158 decreased in 73%, and trigeminal motor deficit improved in 80%. Among @entity1 with preoperative abducent nerve paresis, recovery was attained in 63%. Three @entity1 (12%) experienced a persistent new or worse @entity129 postoperatively. @entity21591 persisted in one of these @entity1 , @entity2359 in another, and motor trigeminal weakness in the third @entity1 . In all @entity1 a good surgical outcome was achieved. One @entity1 died 2 years after treatment from an unrelated cause. In three @entity1 the @entity5 recurred after an average of 22.3 months. CONCLUSIONS: Preservation or improvement of @entity129 can be achieved through total removal of a @entity808 , and skull base approaches are better suited to achieving this goal. The zygomatic middle fossa approach is particularly helpful and safe. It allows @entity5 removal from the cavernous sinus, the infratemporal fossa, and the posterior fossa through the expanded Meckel cave.
