Article
Outcome after microsurgery for meningiomas involving the internal acoustic canal
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Authors
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K. von Eckardstein
- Klinik für Neurochirurgie, Universitätsklinikum Göttingen, Deutschland
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C. Driscoll
- Mayo Clinic and Foundation, Rochester, MN
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V. Rohde
- Klinik für Neurochirurgie, Universitätsklinikum Göttingen, Deutschland
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M. Link
- Mayo Clinic and Foundation, Rochester, MN
| Published: | May 20, 2009 |
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Outline
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Objective: Petrosal meningiomas which grow into the internal acoustic canal (IAC) are occasionally seen. However, meningiomas which originate in the IAC or truly extend into the IAC are very infrequent. Information on the pre- and postoperative functions of the facial and the cochlear nerve in this distinct tumor entity are lacking. The aim of this study is to review a single surgeon’s experience with this subset of posterior fossa meningiomas and to report formal audiogram scores and facial nerve functions.
Methods: We conducted a retrospective chart review of consecutive patients with meningiomas truly involving the IAC or originating in the IAC. We report pre- and postoperative House-Brackmann grades for facial nerve function and pre- and postoperative AAO-HNS hearing class for all of our patients. The majority of patients was operated using the suboccipital approach. The median follow-up was 29 months.
Results: We identified 19 patients with meningiomas originating in or extending into the internal auditory canal. The intracanalicular extension was between 6 and 14 mm, the median intracranial tumor component volume was 5cm³. Preoperative facial nerve function was normal in 17 patients, and remained stable postoperatively in 14 patients at three months. Twelve patients had class A hearing preoperatively, nine of which presented with full hearing at three months. Four patients had worsening of hearing. Other complications included a cerebellar hematoma in one patient and a fourth nerve palsy in two patients. Complete tumor removal was achieved in all patients.
Conclusions: In this retrospective chart review we have focussed on patients with posterior fossa meningiomas originating in or extending into the IAC; up to now this series is the largest in this specific subset of petrosal meningiomas. Preservation of full facial nerve function was possible in 76% of patients; preservation of at least useful hearing (class A and B) was possible in 92% of patients presenting with full hearing, suggesting that complete tumor removal could be achieved with acceptable rates of transient morbidity.
