Surgical strategy for trigeminal schwannomas

Recent advances in skull base surgery and insight to the membranous structures surrounding the trigeminal nerve have contributed to the safe and complete removal of the trigeminal schwannomas. We have proposed a MPE classification for the trigeminal schwannomas according to their origin and extension patterns. Types M, V, and E are tumors involving a single compartment, that is, the middle fossa, posterior fossa, or extracranial space, respectively. Types MP (middle and posterior fossae), ME (middle fossa and extracranial space), or MPE (middle and posterior fossae and extracranial space) are tumors involving multiple compartments. The surgical strategy for these various trigeminal schwannomas based on the analysis of their developmental patterns is described.