Outcome after microsurgery for meningiomas involving the internal auditory canal.
BACKGROUND
The subset of patients suffering from meningiomas truly originating in or extending into the internal auditory canal is not well described in the literature.


OBJECTIVE
To evaluate postoperative facial motor and hearing outcomes in patients undergoing resection of meningiomas originating in or extending into the internal auditory canal.


METHODS
Chart reviews were done of 19 consecutive patients undergoing surgery for meningiomas originating in or extending into the internal auditory canal at the Mayo Clinic, Rochester, with emphasis on clinical exam and audiometry.


RESULTS
Median follow-up for the entire group was 29 months. Seventy-four percent of patients had stable facial nerve function. One patient experienced improvement. Postoperative cochlear nerve function was unchanged in 74% of patients and worsened in 21% of patients. One patient with a sudden preoperative hearing loss improved to full hearing at 3 months.


CONCLUSIONS
Every attempt should be made to preserve hearing and facial motor function in surgical removal of posterior fossa meningiomas that originate in or extend into the internal auditory canal. Normal or nearly normal facial nerve function can be preserved in 88% of patients presenting with normal facial nerve function; serviceable hearing can be preserved in 92% of patients who present with normal hearing. A standard retrosigmoid craniotomy with drilling of the posterior canal wall of the internal auditory canal worked well in the majority of cases.
von Eckardstein
Kajetan L
KL
Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
Driscoll
Colin L W
CL
Link
Michael J
MJ
D000328:Adult; D000368:Aged; D004424:Ear Canal / Q000601:surgery; D005158:Facial Paralysis / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D034381:Hearing Loss / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications* / Q000601:surgery*; D008579:Meningioma / Q000150:complications* / Q000601:surgery*; D008875:Middle Aged; D016896:Treatment Outcome