Two-Stage Resection of a Giant Trigeminal Schwannoma in a Non-Neurofibromatosis Type 2 Pediatric Patient: A Case Report, Systematic Review, and Intraoperative Video

World Neurosurg. 2023 Mar:171:e323-e335. doi: 10.1016/j.wneu.2022.12.017. Epub 2022 Dec 13.


Background: Trigeminal schwannoma is an uncommon tumor in pediatric patients. Several surgical approaches have been described in the literature.

Methods: The case of an 11-year-old boy with a giant dumbbell-shaped trigeminal schwannoma removed through a 2-stage approach was presented with an intraoperative video. Using PubMed and Scopus, the literature on trigeminal schwannoma in pediatric patients was searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

Results: The search strategy yielded 312 titles, of which 13 were included in the review. Cases of trigeminal schwannoma were described, with a highly variable clinical presentation and anatomical arrangement in cranial fossae. Two-stage approaches were reported, although most studies described single-stage approaches. Common postoperative outcomes were a range of disturbances of cranial nerve V.

Conclusions: The surgical approach varies based on the tumor conformation. However, a 2-stage pterional subtemporal and semisitting retrosigmoid approach is a safe, practical, and effective strategy for the removal of dumbbell-shaped trigeminal schwannoma in a pediatric patient.

Keywords: Pediatrics; Pterional subtemporal approach; Retrosigmoid approach; Semisitting position; Trigeminal schwannoma.

Publication types

  • Case Reports
  • Systematic Review
  • Video-Audio Media

MeSH terms

  • Child
  • Cranial Nerve Neoplasms* / surgery
  • Humans
  • Male
  • Neurilemmoma* / surgery
  • Neurosurgical Procedures
  • Trigeminal Nerve / surgery
  • Trigeminal Nerve Diseases* / surgery