Posterior fossa meningioma with invasion of the internal acoustic canal

Peraio, S; Fh, Ebner; Tatagiba, Marcos

doi:10.1007/s00701-018-3623-8

Cited by 7 publications

(6 citation statements)

References 26 publications

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“…The white, light blue, and blue columns represent normal, partial palsy, and complete palsy, respectively. meningioma in 174 patients (28). Therefore, in this study, we found an increased risk of ANP in PCM surgery, probably because the IAC is very close to the Dorellos canal and the risk of nerve damage during tumor manipulation is increased rather than the IAC invasion itself is dangerous (30)(31)(32).…”

Section: Discussionmentioning

confidence: 50%

“…Agarwal et al reported that there was no association between IAC invasion and CN deficit in 34 cerebellopontine angle meningioma surgeries (29). In addition, Peraio et al reported that tumor removal with intracranial IAC drilling did not increase the risk of CN injury in a study reporting the surgical results of posterior fossa meningioma in 174 patients (28). Therefore, in this study, we found an increased risk of ANP in PCM surgery, probably because the IAC is very close to the Dorellos canal and the risk of nerve damage during tumor manipulation is increased rather than the IAC invasion itself is dangerous (30–32).…”

Section: Discussionmentioning

confidence: 99%

“…IAC Invasion is not reported to be associated with postoperative cranial journalism in general meningioma surgeries (28,29). Agarwal et al reported that there was no association between IAC invasion and CN deficit in 34 cerebellopontine angle meningioma surgeries (29).…”

Section: Discussionmentioning

confidence: 99%

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Factors Associated With Abducens Nerve Palsy in Patients Undergoing Surgery for Petroclival Meningiomas

Yoo¹,

Lim²,

Jung³

et al. 2021

Journal of Neuro-Ophthalmology

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Background:During the surgical resection of petroclival meningiomas, preserving the cranial nerves is crucial. The abducens nerve is particularly vulnerable during surgery. However, the preoperative risk factors and postoperative prognosis of abducens nerve palsy (ANP) are poorly understood.Methods:We retrospectively analyzed 70 patients who underwent surgery for petroclival meningiomas between May 2010 and December 2019, divided into gross-total resection (GTR) and subtotal resection (STR) groups. The relationship of preoperative clinical factors with the incidence and recovery of postoperative ANP was analyzed.Results:Postoperative ANP was observed in 23 patients (32.9%). Multivariable logistic regression revealed that the tumor-to-cerebellar peduncle T2 imaging intensity index (TCTI) (P < 0.001) and internal auditory canal invasion (P = 0.033) contributed to postoperative ANP. GTR was achieved in 37 patients (52.9%), and 10 (27.0%) of them showed ANP. STR was achieved in 33 patients (47.1%), and 13 (39.4%) of them showed ANP. Recovery from ANP took a median of 6.6 months (range, 4.5–20.3 months). At 6 months after the operation, recovery of the abducens nerve function was observed in 16 patients (69.0%); of whom, 4 (40.0%) were in the GTR group and 12 (92.3%) were in the STR group (P = 0.025).Conclusions:TCTI and internal auditory canal invasion were the risk factors for postoperative ANP. Although intentional STR did not prevent ANP immediately after the operation, recovery of the abducens nerve function after surgery was observed more frequently in the STR group than in the GTR group.

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Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 99%

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Factors Associated With Abducens Nerve Palsy in Patients Undergoing Surgery for Petroclival Meningiomas

Yoo¹,

Lim²,

Jung³

et al. 2021

Journal of Neuro-Ophthalmology

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“…However, it should be noted that ear preference strength has been mapped to audiometric interaural threshold difference (33), and the DHI is a validated instrument. Whereas the study cohort is not the largest to report audiovestibular outcomes in posterior fossa meningioma (24,9), it is the only study to examine long-term hearing, tinnitus, balance, and quality of life in an integrated manner, as most other studies focus on perioperative complications or Karnofsky performance status. The large difference in response rates between the two cohorts is notable as well.…”

Section: Discussionmentioning

confidence: 99%

Differences in Hearing, Balance, and Quality-of-Life Outcomes in Petroclival Versus Nonpetroclival Posterior Fossa Meningiomas

et al. 2023

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Objective: To compare hearing, tinnitus, balance, and quality-oflife treatment outcomes of petroclival meningioma and nonpetroclival cerebellopontine angle meningioma cohorts. Study Design: A retrospective cohort study of 60 patients with posterior fossa meningiomas, 25 petroclival and 35 nonpetroclival, who were treated at a single tertiary care center between 2000 and 2020. Intervention: A survey battery that included the Hearing Effort of the Tumor Ear, Speech and Spatial Qualities of Hearing, Tinnitus Functional Index, Dizziness Handicap Inventory (DHI), and Short Form Health Survey. Petroclival and nonpetroclival cohorts were matched for tumor size and demographic features. Main Outcome Measures: Differences between groups in hearing, balance outcomes, and quality of life and patient factors that influence posttreatment quality of life. Results: Petroclival meningioma patients reported poorer audiovestibular outcomes with a higher rate of deafness in the tumor ear (36.0% versus 8.6%, p = 0.032) and lower functional hearing by the Hear-ing Effort of the Tumor Ear, Speech and Spatial Qualities of Hearing (76.6 [6.1] versus 82.0 [4.4], p < 0.001). Current dizziness rate was higher (48.0% versus 23.5%, p = 0.05), with more severe dizziness by DHI (18.4 [4.8] versus 5.7 [2.2], p < 0.001). Both cohorts had similar high quality of life and low tinnitus severity indices. Quality-of-life Short Form Health Survey predictors were tumor size ( p = 0.012) and DHI ( p = 0.005) in multivariable analysis. Conclusions: Hearing and dizziness treatment outcomes of petroclival meningioma are poorer relative to other posterior fossa meningiomas. Despite audiovestibular outcome distinctions, the overall posttreatment quality of life was high for both petroclival and nonpetroclival meningioma.

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“…Suboccipital/ retrosigmoid approaches are most commonly employed in most case series and constitute a plurality of approaches utilized in the present series. Some authors have reported good results exclusively utilizing the retrosigmoid approach [6,11,12]. Other approaches to these tumors reported in the literature include trans-petrosal approaches (including translabyrinthine, transcochlear, combined petrosal, extended middle fossa / 'Kawase' approaches, etc.…”

Section: Choice Of Approachmentioning

confidence: 99%

Predictors of hearing functional outcome following surgery for cerebellopontine angle meningioma

et al. 2022

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Cerebellopontine angle (CPA) meningioma can affect hearing function and require expeditious treatment to prevent permanent hearing loss. The authors sought to determine the factors associated with hearing functional outcome in CPA meningioma patients treated with surgery and/or radiation therapy either stereotactic radiosurgery or stereotactic radiation therapy. METHODSConsecutive patients with CPA meningioma who had presented at our hospital from 2008 to 2018 were identi ed through retrospective chart review. Hearing function-pure tone audiogram (PTA) and speech discrimination score (SDS)-was assessed before and after surgery for CPA meningioma. Hearing function with PTA>50 dB and SDS<69% were de ned as poor hearing functional outcome. Multivariable Cox Proportional Hazards Regression model was used to assess the associations between pre-operative hearing functional assessment and post-operative hearing functional outcomes. RESULTSThe study cohort included 31 patients (80.6% females, with a mean age of 61.3±15.2 years) with a median clinical follow-up of 5 months (range, 1 week-98 months). The mean pre-operative PTA and SDS were 23.8±11.2 dB and 64.4±22.2% respectively. At the last visit, there was a signi cant hearing recovery, with an improvement of 29.7±18.0 dB (p<0.001) and 87.6±17.8% (p<0.001) in PTA and SDS respectively.Multivariable cox proportional hazards regression model was conducted after adjusting for age, gender, tumor volume, location, and classi cation of the tumor, which revealed that patients undergoing surgery through retro sigmoid approach [Hazards Ratio (HR): 32.1, 95% Con dence Interval (CI): 2.11-491.0, p=0.01] and gross total resection (GTR) (HR: 2.99, 95%CI: 1.09-9.32, p=0.05) had signi cantly higher risk of poor hearing functional outcome. Moreover, patients with poor preoperative hearing had 85% higher chances of poor hearing functional outcome post operatively (HR: 0.15, 95%CI: 0.03-0.59, p=0.007). CONCLUSIONPostoperative improvement in hearing is a reasonable expectation following surgery for CPA meningioma. Preoperative hearing, surgical approach and extent of surgical resection are predictive of postoperative hearing function outcome and can identify patients at higher risk of hearing loss.

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Posterior fossa meningioma with invasion of the internal acoustic canal

Cited by 7 publications

References 26 publications

Factors Associated With Abducens Nerve Palsy in Patients Undergoing Surgery for Petroclival Meningiomas

Factors Associated With Abducens Nerve Palsy in Patients Undergoing Surgery for Petroclival Meningiomas

Differences in Hearing, Balance, and Quality-of-Life Outcomes in Petroclival Versus Nonpetroclival Posterior Fossa Meningiomas

Predictors of hearing functional outcome following surgery for cerebellopontine angle meningioma

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