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April2012 Vol.49 Issue:        2        Table of Contents
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Surgical Results and Clinical Outcome of Medially Located Cerebello-Pontine Angle Meningiomas

Omar M. El-Falaky


Department of Neurosurgery, Cairo University; Egypt




ABSTRACT

Background: Meningiomas are the second most common tumor occupying the cerebello-pontine angle (CPA). Medially located tumors are more difficult to remove. A preoperative anticipation of the exact location of these tumors and relation to the neighboring neurovascular structures enables a proper surgical planning and thus better clinical outcome  Objective: The aim of this study is to analyze the results of a group of patients harboring cerebello-pontine angle meningiomas originating from the posterior petrous bone in relation with, or extending anterior to the internal auditory meatus, regarding the clinical presentation, surgical outcome, and complications. Methods: In a series of 9 patients with antero-medially located CPA meningiomas operated upon in Cairo University Hospitals between 2007 and 2011, data was collected and reviewed. A special emphasis was directed to tumor size, neurological presentation, site of tumor origin and extent of resection and post operative clinical outcome. Results: Gross total resection of the tumor (Simpson G I and II) was achieved in 78% (7/9 cases), subtotal resection in 2 cases. Acquired permanent facial nerve deficit occurred in one case (11%). No Acquired post operative hearing impairment was recorded. Conclusion: A thorough preoperative radiological evaluation anticipates the relationship of the tumor with the facial vestibulo-cochlear complex and coupled with intra operative microscopic view, helps a great deal in sparing injury of these nerves and thus minimizing the postoperative morbidity. The lateral sub occipital approach proved to be a reliable approach in such tumors. [Egypt J Neurol Psychiat Neurosurg.  2012; 49(2): 99-104]

 

Key Words: cerebello-pontine angle, meningioma, microsurgery, sub occipital approach

Correspondence to Omar M. El-Falaky, Department of Neurosurgery, Cairo University; Egypt.

E-mail: omarfalaky@hotmail.com   Tel.: 01223954993





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