Türk Nöroşirürji Dergisi 2011 , Vol 21 , Num 2
Meningiomas of the Cerebello-Pontine Angle
Şişli Etfal Eğitim ve Araştırma Hastanesi, Nöroşirürji Kliniği, İstanbul AIM: Meningiomas of the cerebellopontine angle (CPA) present a formidable surgical challenge due to tumor vascularity, neural attachment, and brain stem compression. The aim of this study was to assess the morbidity and mortality of meningioma surgery in patients harbouring a tumour at the CPA as one representative location of the posterior fossa.

MATERIAL and METHODS: Twenty seven patients with meningiomas of the CPA were surgically treated through a retrosigmoid approach at Neurosurgery Clinic of Şişli Etfal Education and Research Hospital from 1994 through 2011. Surgeries were done by the senior author (YA). Data was collected from a retrospective medical records review.

RESULTS: Total tumor removal (Simpson Grade I + II) was achieved in 25 of 27 (92.6%) of the patients. Although the facial nerve was anatomically preserved in all cases, transient worsening of more than 1 House and Brackmann grade was observed in 5 patients (18.5%). Cerebrospinal fluid leak was seen in 4 (14.8%) patients and additional transient cranial nerve deficits were noted in 3 (11.1%) cases, but no significant neurological sequelae occurred. The median Karnofsky score at presentation was 80 (60–90). There was no peri-operative mortality in our series. Length of hospital stay was 15.2 days (7–42 days). The postoperative median Karnofsky score at time of discharge was 80 (50–90). The late postoperative (mean 27 months) median Karnofsky score was 85 (70-100).

CONCLUSION: Using modern neurosurgical techniques and neuroanesthesia, patients with CPA meningiomas can be operated on with acceptable low morbidity and good neurological outcome. Anahtar Kelimeler : Cerebellopontine angle, Facial nerve, Meningioma, Retrosigmoid approach