Surgical Treatment of Secondary Trigeminal Neuralgia Induced by Cerebellopontine Angle Tumors: A Single-Center Experience

Objective: Secondary trigeminal neuralgia (TN) caused by cerebellopontine angle (CPA) tumors are rare, although TN may be a primary manifestation in the neurosurgery department. In this study, we aimed to retrospectively assess patients with CPA tumor-induced TN from a single center.

Methods: Of 819 consecutive patients with TN treated at our center between 2007 and 2017, 36 with CPA tumor-induced TN were enrolled, and their medical and surgical records were analyzed.

Results: The 36 patients accounted for 4.4% of all patients with TN. A comparison of patients with classic and tumor-induced TN indicated significant intergroup differences in the mean age at surgery (58.94 vs. 49.33 years, P = 0.000), the mean age at onset of TN (52.01 vs. 38.04 years), and affected side (298/485 vs. 22/14 in left/right, P = 0.006); no such difference was noted in the sex ratio (0.598 vs. 0.385, P = 0.214). The rates of excellent, good, and fair clinical outcomes were 80.56%, 13.89%, and 2.78%, respectively. The offending vessels found during surgery included the superior and anterior inferior cerebellar arteries in 3 and 4 cases, respectively. Postoperative complications included aseptic meningitis (1 case), facial numbness (2 cases), hearing disturbance (3 cases), facial palsy (4 cases), hemorrhage (1 case), and diplopia (2 cases).

Conclusions: Secondary TN caused by CPA tumors is not as frequent as classic TN. Compared with classic TN, tumor-induced TN is characterized by symptom onset and surgery at a younger age. Direct compression rather than chemical irritation is the cause of secondary TN.