title: Clinical and surgical considerations for cerebellopontine angle meningiomas.
abstract: We retrospectively reviewed 24 patients with cerebellopontine angle (CPA) meningioma from our institution to describe the clinical and surgical significance of extensions into the internal auditory canal (IAC). Of these patients, 62% had invasion of the IAC, which was associated with high rates of unilateral hearing loss at presentation (67% versus [vs.] 22%, p<0.05). A retrosigmoid approach was used in 22/24 patients, of whom 13 had an IAC extension. In five patients, IAC drilling was needed to achieve a more complete resection and 20 patients of the 22 (91%) had improved or stable hearing postoperatively, and one patient had permanent facial paralysis. Cranial nerve IX and X were the most common complications (17% and 33% respectively), and were almost exclusively associated with resection of tumor extensions into the jugular foramen (p<0.01). We conclude that CPA meningiomas can be removed with excellent rates of hearing and facial nerve preservation. Caution must be used when attempting to resect tumor extensions into the jugular foramen given the high rates of lower CN complications.
authors.affiliation: Department of Neurological Surgery, Brain Tumor Research Center, University of California at San Francisco, San Francisco, CA 94143, USA.
authors.forename: Ari J
authors.initials: AJ
authors.lastname: Kane
authors.forename: Michael E
authors.initials: ME
authors.lastname: Sughrue
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Rutkowski
authors.forename: Mitchel S
authors.initials: MS
authors.lastname: Berger
authors.forename: Michael W
authors.initials: MW
authors.lastname: McDermott
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Parsa
mesh_terms: D000328:Adult; D000368:Aged; D002530:Cerebellopontine Angle / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006309:Hearing / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology* / Q000601:surgery*; D008579:Meningioma / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D055815:Young Adult