Natural History, Multimodal Management, and Quality of Life Outcomes of Trigeminal Schwannomas
Notice bibliographique
Résumé
Background Trigeminal schwannomas are the second most common among intracranial schwannomas. These can arise from anywhere between the root and the distal extracranial branches of the trigeminal nerve. Clinical presentation depends on location and size, including but not limited to facial hypesthesia or pain, headaches, dizziness, ataxia, and diplopia. Literature is strikingly scant discussing the natural history of these lesions, while the treatment goals are heavily dependent on tumor presentation. Management decisions must be individualized to each tumor and each patient, while attempting to maximize the quality of life. We present the natural history of these lesions as well as their management by surgical resection or radiation therapy, and report long-term quality of life outcomes. Methods Between 2001 and 2015, 24 patients (66.7% female) with trigeminal schwannomas were diagnosed and managed at Vancouver General Hospital. We analyzed the clinical presentation, surgical results, resection rates, patient quality of life, and complications. To complete the evaluation, we prospectively collected 36-Item Short Form Health Survey (SF-36) quality of life assessments for comparison. Results We identified 12 patients treated with a craniotomy and surgical resection, 4 were treated with radiation therapy, while 8 patients were followed by observation. Mean age of study cohort was 49.2 years (range, 23–79 years), and most patients presented with facial hypesthesia (54.2%) and headaches (37.5%), while 37.5% were incidental findings. There were no major differences in patient demographics between the three groups. Patients offered surgery had larger lesions (mean diameter, 3.4 ± 1.1 cm) when compared with those that were irradiated or observed, and were more likely to have extracranial extension. Overall patient quality of life improved following treatment (ΔSF-36 + 12.9) at 3.9 years. Conclusions The treatment goals of trigeminal schwannomas focus on improvement in neurologic symptoms, relief of mass effect, and preservation of cranial nerve function. We demonstrate that smaller lesions found incidentally with minimal symptoms can be followed safely with serial imaging, with 1 of 9 (11.1%) progressing to require treatment over the course of 7.1 years. Management of trigeminal schwannomas should be individualized with an involvement of a multidisciplinary skull base team.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».