Abstract：
Although typically benign, trigeminal schwannomas (TS) may require surgical resection when large or symptomatic and can cause significant morbidity. This study aims to summarize the literature and synthesize outcomes following surgical resection of TS. A systematic review was performed according to PRISMA guidelines. Data extracted included patient and tumor characteristics, surgical approaches, and postoperative outcomes. Odds ratios (OR) with corresponding 95% confidence intervals (CI) were used for outcome analysis. The initial search yielded 1838 results, of which 26 studies with 974 patients undergoing surgical resection of TS were included. The mean age was 42.9 years and 58.0% were female. The mean tumor diameter was 4.7 cm, with Samii type A, B, C, and D tumors corresponding to 33.4%, 15.8%, 37.2%, and 13.6%, respectively. Over a mean symptom duration of 29 months, patients presented with trigeminal hypesthesia (58.7%), headache (32.8%), trigeminal motor weakness (22.8%), facial pain (21.3%), ataxia (19.4%), diplopia (18.7%), and visual impairment (12.0%). Surgical approaches included supratentorial (61.4%), infratentorial (15.0%), endoscopic (8.6%), combined/staged (5.3%), and anterior (5.7%) or posterior (4.0%) petrosectomy. Postoperative improvement of facial pain (83.9%) was significantly greater than trigeminal motor weakness (33.0%) or hypesthesia (29.4%). The extent of resection (EOR) was reported as gross total (GTR), near total, and subtotal in 77.7%, 7.7%, and 14.6% of cases, respectively. Over a mean follow-up time of 62.6 months, recurrence/progression was noted in 7.4% of patients at a mean time to recurrence of 44.9 months. Patients with GTR had statistically significantly lower odds of recurrence/progression (OR: 0.07; 95% CI: 0.04-0.15) compared to patients with non-GTR. This systematic review and meta-analysis report patient outcomes following surgical resection of TS. EOR was found to be an important predictor of the risk of recurrence. Facial pain was more likely to improve postoperatively than facial hypesthesia. This work reports baseline rates of post-operative complications across studies, establishing benchmarks for neurosurgeons innovating and working to improve surgical outcomes for TS patients.
摘要：
虽然通常是良性的，三叉神经鞘瘤（TS）在大或有症状时可能需要手术切除，并可能导致严重的发病率。本研究旨在总结文献并综合手术切除TS后的结果。根据PRISMA指南进行系统评价。提取的数据包括患者和肿瘤特征，手术方法,和术后结果。将比值比(OR)和相应的95%置信区间(CI)用于结果分析。最初的搜索产生了1838个结果，其中26项研究纳入974例接受TS手术切除的患者。平均年龄为42.9岁，58.0％为女性。平均肿瘤直径4.7cm,SamiiA型,B,C,和D肿瘤对应的33.4％，15.8%,37.2%,和13.6%，分别。在29个月的平均症状持续时间内，患者出现三叉神经感觉减退（58.7％），头痛(32.8%)，三叉神经运动无力（22.8%），面部疼痛(21.3%)，共济失调（19.4%），复视（18.7%），视力障碍（12.0%）。手术入路包括幕上（61.4%），鼻下（15.0%），内镜（8.6%），合并/分期（5.3%），和前部（5.7％）或后部（4.0％）岩石切除术。术后面部疼痛的改善（83.9％）明显大于三叉神经运动无力（33.0％）或感觉减退（29.4％）。切除程度（EOR）报告为总总（GTR），接近总量,小计占77.7%，7.7%,和14.6%的病例，分别。在62.6个月的平均随访时间内，7.4%的患者出现复发/进展,平均复发时间为44.9个月.与非GTR患者相比，GTR患者的复发/进展几率在统计学上显着降低（OR：0.07;95％CI：0.04-0.15）。本系统评价和荟萃分析报告了手术切除TS后的患者预后。发现EOR是复发风险的重要预测因子。术后面部疼痛比面部感觉减退更有可能改善。这项工作报告了研究中术后并发症的基线率，为神经外科医生的创新和工作建立基准，以改善TS患者的手术结果。
