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80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

20.05. - 24.05.2009, Rostock

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Microsurgical treatment of meningiomas of cerebellopontine angle with internal auditory canal extension

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  • corresponding author Martin Chovanec - 1st Faculty of Medicine, Charles Univ., Dept. of ORL & HNS, Prague 5, Tsch. Republik
  • E. Zverina - 1st Faculty of Medicine, Charles Univ., Dept. of ORL & HNS, Prague 5, Tsch. Republik
  • Jan Betka - 1st Faculty of Medicine, Charles Univ., Dept. of ORL & HNS, Prague 5, Tsch. Republik
  • J. Skrivan - 1st Faculty of Medicine, Charles Univ., Dept. of ORL & HNS, Prague 5, Tsch. Republik
  • J. Kluh - 1st Faculty of Medicine, Charles Univ., Dept. of ORL & HNS, Prague 5, Tsch. Republik
  • P. Lukes - 1st Faculty of Medicine, Charles Univ., Dept. of ORL & HNS, Prague 5, Tsch. Republik
  • J. Kraus - 2nd Faculty of Medicine, Charles Univ., Dept. of Pediatric Neurology, Prague 5, Tsch. Republik

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 80. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Rostock, 20.-24.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09hnod605

doi: 10.3205/09hnod605, urn:nbn:de:0183-09hnod6051

Published: April 17, 2009

© 2009 Chovanec et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Introduction: Meningiomas represent 2nd most common tumor of cerebellopontine angle (CPA). Tumors with internal auditory canal extension are rare.

Materials and methods: Retrospective analysis of 14 microsurgically treated meningiomas of CPA with internal auditory canal extension during 1997-2007 (female/male: 11/3; 27-66 years; 1 NF2 associated, 13 sporadic cases). All tumors were large compressing cerebellum and brainstem. 1 tumor extended through the jugular foramen to the parapharyngeal space. The most common symptom were hearing loss (100%), tinnitus (87%), instability (73%) and trigeminal dysfunction (33%).

Results: Retrosigmoid approach was applied in 13 patients. In 1 case it was combined retrolabyrinthine and infratemporal approach. Radical removal (Simpson grade 1 and 2) was achieved in 86% and subtotal resection (Simpson grade 4) in 14%. 1 of these patients has undergone adjuvant external irradiation. Transient postoperative CN VII dysfunction (HB III) was observed in only 14. Preoperatively useful hearing preservation was achieved in 83% cases and in another 21% of preoperatively non-useful hearing ears it improved into useful level. Improvement of preoperative CN V dysfunction occured in all cases. Transitory dysfunction of CN V and IX-X were observed in 14% of cases. Follow-up is 1-9 years. The only recurrence observed was in 1 patient with subtotal resection which was further treated with LGN.

Conclusion: CPA meningiomas with internal auditory canal extension are rare. Radical microsurgical removal with anatomical and functional preservation of CNs is possible in majority of cases. Hearing improvement after surgery can be expected in significant number of patients.

Unterstützt durch: This work was supported by IGA MZ CR NS/9909-3