Preoperative and postoperative auditory and facial nerve function in cerebellopontine angle meningiomas

Abstract

Preoperative and postoperative facial nerve and auditory function were reviewed retrospectively in 13 cases of cerebellopontine angle meningiomas. According to their location within the posterior fossa and with special reference to the internal auditory canal, they were classified into a premeatal and a retromeatal group. All the tumors were removed by an otoneurosurgical team by use of a retrosigmoid approach. Postoperative results (1 year after operation) were compared within the two groups with respect to preservation of hearing (normal hearing in 31% and preservation of preoperative hearing in 69% of the cases) and facial nerve function (no or mild postoperative impairment in 69% of the cases). Both preoperative and postoperative impairment of facial nerve and auditory function prevailed in the premeatal group. For preservation of vital vascular and central nervous structures, subtotal resection with consecutive fractionated radiation therapy had to be performed in 30% of the cases. Our results provide substantial evidence that in cerebellopontine angle meningiomas a precise preoperative study of tumor location will assist in improving individual operative strategy and thus postoperative functional results.

Hemifacial Spasm Due to Cerebellopontine Angle Meningiomas. Two Case Reports.

“…Subtotal resection and fractionated radiation therapy can preserve the vascular and central nervous structures in some cases of cerebellopontine angle meningiomas. 11) We have also obtained excellent results in the use of radiosurgery for the skull base meningiomas. 5) The tumor tissue surrounding and adhering to the cranial nerves may be left for radiosurgery to preserve cranial nerve function in the case of cerebellopontine angle meningioma.…”

The Classification of Posterior Petrous Meningiomas and Its Clinical Significance

“…Intra-operative nerve monitoring should be implemented in order to avoid unnecessary injury if the cranial nerves are difficult to recognize because of tumour erosion and compression. 9 Vital blood vessels, such as the anterior and posterior inferior cerebellar arteries and the superior cerebellar artery, must be separated carefully. No vessels should be amputated by electrocoagulation until it has been verified that the vessel only supplies blood to the tumour.…”

Classification of Meningiomas in the Cerebellopontine Angle

“…It may grow outward toward the skull, causing the skull to thicken (Samii and Ammirati 1991 ;Samii and Draf 1989 ;Schaller 2005 ). Some of them may also contain cysts, small deposits of calcium or tightly packed bunches of blood vessels (Schaller et al 1995(Schaller et al , 1999a.…”