Abstract：
To observe the evolution and outcomes of postoperative trigeminal neuropathy following surgery of tumor involving the trigeminal nerve.
A prospective observational study was conducted between October 2018 and February 2019 involving 25 patients with tumors confirmed to involve the trigeminal nerve during surgery by senior author. Pre- and postoperative trigeminal nerve function status and clinical data were recorded.
This study included 18 cases of meningioma and seven of trigeminal schwannoma. Among the meningioma cases, 55.6% of the patients reported facial sensory dysfunction before surgery, 33.3% presented ocular discomfort, and 5.6% had masticatory muscle atrophy. Postoperatively, all patients experienced facial paresthesia, 94.4% complained of eye dryness, and one (5.56%) exhibited keratitis. Additionally, one patient (5.56%) showed new-onset masticatory weakness. During follow-up, 50.0% of patients reported improvement in facial paresthesia, and one (5.56%) experienced deterioration. Eye dryness resolved in 35.3% of patients, and keratitis remission was observed in one patient. However, one patient (5.56%) developed neurotrophic keratitis. Overall, 55.6% of patients displayed mild masticatory weakness without muscle atrophy. In the cases of schwannoma, 28.6% of patients had facial paresthesia before surgery, 42.9% showed ocular discomfort, and one (14.3%) complained of masticatory dysfunction. Postoperatively, 85.7% of patients reported facial paresthesia and eye dryness, with one patient (16.7%) experiencing keratitis. During follow-up, 66.7% of patients demonstrated improvement in facial paresthesia, 28.6% showed eye dryness remission, and one patient (16.7%) recovered from keratitis. However, one patient (16.7%) developed new-onset neurotrophic keratitis. One patient (16.7%) experienced relief of masticatory dysfunction, but 42.9% reported mild deterioration. Another patient (14.3%) had facial anesthesia that had not improved.
Postoperative trigeminal neuropathy is a common complication with a high incidence rate and poor recovery outcomes after surgery for tumors involving the trigeminal nerve. When trigeminal nerve damage is unavoidable, it is essential to provide a multidisciplinary and careful follow-up, along with active management strategy, to mitigate the more severe effects of postoperative trigeminal neuropathy.
A prospective observational study was conducted between October 2018 and February 2019 involving 25 patients with tumors confirmed to involve the trigeminal nerve during surgery by senior author. Pre- and postoperative trigeminal nerve function status and clinical data were recorded.
This study included 18 cases of meningioma and seven of trigeminal schwannoma. Among the meningioma cases, 55.6% of the patients reported facial sensory dysfunction before surgery, 33.3% presented ocular discomfort, and 5.6% had masticatory muscle atrophy. Postoperatively, all patients experienced facial paresthesia, 94.4% complained of eye dryness, and one (5.56%) exhibited keratitis. Additionally, one patient (5.56%) showed new-onset masticatory weakness. During follow-up, 50.0% of patients reported improvement in facial paresthesia, and one (5.56%) experienced deterioration. Eye dryness resolved in 35.3% of patients, and keratitis remission was observed in one patient. However, one patient (5.56%) developed neurotrophic keratitis. Overall, 55.6% of patients displayed mild masticatory weakness without muscle atrophy. In the cases of schwannoma, 28.6% of patients had facial paresthesia before surgery, 42.9% showed ocular discomfort, and one (14.3%) complained of masticatory dysfunction. Postoperatively, 85.7% of patients reported facial paresthesia and eye dryness, with one patient (16.7%) experiencing keratitis. During follow-up, 66.7% of patients demonstrated improvement in facial paresthesia, 28.6% showed eye dryness remission, and one patient (16.7%) recovered from keratitis. However, one patient (16.7%) developed new-onset neurotrophic keratitis. One patient (16.7%) experienced relief of masticatory dysfunction, but 42.9% reported mild deterioration. Another patient (14.3%) had facial anesthesia that had not improved.
Postoperative trigeminal neuropathy is a common complication with a high incidence rate and poor recovery outcomes after surgery for tumors involving the trigeminal nerve. When trigeminal nerve damage is unavoidable, it is essential to provide a multidisciplinary and careful follow-up, along with active management strategy, to mitigate the more severe effects of postoperative trigeminal neuropathy.
摘要：
目的：观察累及三叉神经的肿瘤术后三叉神经病变的演变及转归。
方法：在2018年10月至2019年2月之间进行了一项前瞻性观察性研究，涉及25例患者，由资深作者在手术过程中证实涉及三叉神经的肿瘤。记录患者术前、术后三叉神经功能状况及临床资料。
结果：本研究包括18例脑膜瘤和7例三叉神经鞘瘤。在脑膜瘤病例中，55.6%的患者术前出现面部感觉功能障碍,33.3%的人出现眼部不适，5.6%有咀嚼性肌肉萎缩。术后,所有患者都有面部感觉异常,94.4%抱怨眼睛干燥，1例(5.56%)出现角膜炎。此外,1例患者(5.56%)出现新发咀嚼无力.随访期间,50.0%的患者报告面部感觉异常有所改善，其中一人(5.56%)出现恶化。35.3%的患者眼干得到缓解，1例患者角膜炎缓解。然而,1例(5.56%)出现神经营养性角膜炎。总的来说,55.6％的患者表现出轻度咀嚼无力，无肌肉萎缩。在神经鞘瘤的病例中,28.6%的患者术前出现面部感觉异常,42.9%表现为眼部不适,1人（14.3%）主诉咀嚼功能障碍。术后,85.7%的患者报告面部感觉异常和眼睛干燥，1例患者（16.7%）出现角膜炎。随访期间,66.7％的患者表现出面部感觉异常的改善，28.6%显示眼睛干燥缓解，1例(16.7%)角膜炎痊愈。然而,1例患者(16.7%)出现新发神经营养性角膜炎.1例患者（16.7%）咀嚼功能障碍缓解，但42.9%报告轻度恶化。另一名患者（14.3％）的面部麻醉没有改善。
结论：术后三叉神经病变是一种常见的并发症，其发病率高，术后恢复效果差。当三叉神经损伤不可避免时，必须提供多学科和仔细的后续行动，随着积极的管理战略，减轻术后三叉神经病变的更严重影响。
方法：在2018年10月至2019年2月之间进行了一项前瞻性观察性研究，涉及25例患者，由资深作者在手术过程中证实涉及三叉神经的肿瘤。记录患者术前、术后三叉神经功能状况及临床资料。
结果：本研究包括18例脑膜瘤和7例三叉神经鞘瘤。在脑膜瘤病例中，55.6%的患者术前出现面部感觉功能障碍,33.3%的人出现眼部不适，5.6%有咀嚼性肌肉萎缩。术后,所有患者都有面部感觉异常,94.4%抱怨眼睛干燥，1例(5.56%)出现角膜炎。此外,1例患者(5.56%)出现新发咀嚼无力.随访期间,50.0%的患者报告面部感觉异常有所改善，其中一人(5.56%)出现恶化。35.3%的患者眼干得到缓解，1例患者角膜炎缓解。然而,1例(5.56%)出现神经营养性角膜炎。总的来说,55.6％的患者表现出轻度咀嚼无力，无肌肉萎缩。在神经鞘瘤的病例中,28.6%的患者术前出现面部感觉异常,42.9%表现为眼部不适,1人（14.3%）主诉咀嚼功能障碍。术后,85.7%的患者报告面部感觉异常和眼睛干燥，1例患者（16.7%）出现角膜炎。随访期间,66.7％的患者表现出面部感觉异常的改善，28.6%显示眼睛干燥缓解，1例(16.7%)角膜炎痊愈。然而,1例患者(16.7%)出现新发神经营养性角膜炎.1例患者（16.7%）咀嚼功能障碍缓解，但42.9%报告轻度恶化。另一名患者（14.3％）的面部麻醉没有改善。
结论：术后三叉神经病变是一种常见的并发症，其发病率高，术后恢复效果差。当三叉神经损伤不可避免时，必须提供多学科和仔细的后续行动，随着积极的管理战略，减轻术后三叉神经病变的更严重影响。
