TY - JOUR
T1 - Clinical and surgical considerations for cerebellopontine angle meningiomas
AU - Kane, Ari J.
AU - Sughrue, Michael E.
AU - Rutkowski, Martin J.
AU - Berger, Mitchel S.
AU - McDermott, Michael W.
AU - Parsa, Andrew T.
N1 - Funding Information:
Ari Kane received a grant from the Howard Hughes Medical Institute and the Ivy Foundation. Dr. Sughrue received a National Research Service Award from the National Institutes of Health and a Neurosurgery Education and Research Foundation grant from the American Association of Neurological Surgeons. Martin Rutkowski received a grant from the Doris Duke Charitable Foundation. Dr. Parsa was partially funded by the Reza and Georgianna Khatib Endowed Chair in Skull Base Tumor Surgery.
PY - 2011/6
Y1 - 2011/6
N2 - 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.
AB - 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.
KW - Cerebellopontine angle
KW - Hearing
KW - Internal auditory canal
KW - Jugular foramen
KW - Meningioma
KW - Vestibular schwannoma
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U2 - 10.1016/j.jocn.2010.09.023
DO - 10.1016/j.jocn.2010.09.023
M3 - Article
C2 - 21507650
AN - SCOPUS:79955888264
SN - 0967-5868
VL - 18
SP - 755
EP - 759
JO - Journal of Clinical Neuroscience
JF - Journal of Clinical Neuroscience
IS - 6
ER -