The Endoscopic Endonasal Approach in Trigeminal Schwannoma Resection: A Systematic Review

Tuesday, October 14, 2025

8:54 AM - 9:00 AM EDT

Location: 125

Disclosure(s):

Taimur Khalid, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: The endoscopic endonasal approach (EEA) has emerged as a promising
treatment for trigeminal schwannomas (TS). However, studies are limited both in
number and sample size. Indications for EEA in management of TS are still unclear.

Methods: A comprehensive literature search was conducted using MEDLINE,
EMBASE, and Web of Science databases from inception through September 29, 2024.
Studies using EEA as the sole approach for management of TS were included. Tumor
location was standardized according to the Jeong classification scheme.

Results: A total of 132 patients from 22 articles were included. Facial numbness was
the most common preoperative symptom (n=57, 43.2%) followed by headache (n=33,
25%). V2 hypoesthesia was present in 36 (27.3%), followed by V1 and V3 hypoesthesia
in 27 (20.5%), and VI palsy in 19 (14.4%). Facial numbness improved in 41 (71.9%),
headache improved in 21 (63.6%), and CN VI palsy improved in 14 (73.7%). There
were 58 (43.9%) patients that developed complications, most commonly CN VI palsy
(n=12, 20.3%), dry eye (n=9, 15.3%), and CN V hypoesthesia (n=7, 11.9%). Gross total
resection (GTR) was attained in 96 (72.7%), near-total resection (NTR) in 16 (12.1%),
and subtotal resection (STR) in 20 (15.2%).

Conclusions: EEA is a well-suited approach for the extirpation of TS. Despite the
aforementioned complications, patients undergoing this approach for TS appreciate
high rates of clinical improvement. While surgeons should endeavor to achieve GTR,
patients may still derive significant benefits from NTR and STR.

Presenting Author(s)

Taimur Khalid, BS

Medical Student
University of Nevada, Las Vegas
Las Vegas, NV, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

AT

Ahmed-Nadeem Tariq, BS

University of Nevada, Las Vegas, United States

Disclosure information not submitted.
AM

Azeem Mahmood Majid, BS

Touro University Nevada College of Osteopathic Medicine, United States

Disclosure information not submitted.
KY

Kurtis C. Young, MD

Resident
University of Nevada, Las Vegas
Foster City, CA, United States

Disclosure information not submitted.
NL

Nathan J. Lloyd, MD

Resident
University of Nevada, Las Vegas Department of Otolaryngology
Henderson, Nevada, United States

Disclosure information not submitted.
WM

William Montagne, MD

University of Nevada, Las Vegas Department of Otolaryngology - Head & Neck Surgery
LAS VEGAS, Nevada, United States

Disclosure information not submitted.
Emily S. Sagalow, MD

Resident
University of Nevada, Las Vegas
Las Vegas, Nevada, United States

Disclosure information not submitted.

Senior Author(s)

RW

Robert C. Wang, MD

Chair, Department of Otolaryngology-Head & Neck Surgery
University of Nevada, Las Vegas
Las Vegas, Nevada, United States

Disclosure information not submitted.