LONG-TERM OUTCOME AFTER OPERATION FOR TRIGEMINAL NEURALGIA IN PATIENTS WITH POSTERIOR-FOSSA TUMORS

During a 20-year period, 26 patients with typical symptoms of trigemin al neuralgia were found to have posterior fossa tumors at operation. T hese cases included 14 meningiomas. eight acoustic neurinomas, two epi dermoid tumors, one angiolipoma, and one ependymoma. The median patien t age was 60 years and 69% of the patients were women. Sixty-five perc ent of the symptoms were left sided. The median preoperative duration of symptoms was 5 years. The distribution of pain among the three divi sions of the trigeminal nerve was similar to that found in patients wi th trigeminal neuralgia who did not have tumors; however, more divisio ns tended to be involved in the tumor patients. The mean postoperative follow-up period was 9 years. At operation, the root entry zone of th e trigeminal nerve was examined for vascular cross-compression in 21 p atients. Vessels compressing the nerve at the root entry zone were obs erved in all patients examined. Postoperative pain relief was frequent and long lasting. Using Kaplan-Meier methods the authors estimated ex cellent relief in 81% of the patients 10 years postoperatively, with p artial relief in an additional 4%.