ORIGINAL ARTICLES   

Journal of Neurosurgical Sciences 2003 September;47(3):129-35

Copyright © 2004 EDIZIONI MINERVA MEDICA

lingua: Inglese

Cerebellopontine angle meningiomas Clinical features and surgical treatment

Gerganov V. ¹, Bussarsky V. ¹, Romansky K. ¹, Popov R. ¹, Djendov S. ², Dimitrov I. ²

¹ Department of Neurosurgery Alexander’s University Hospital, Sofia, Bulgaria 2 Department of Radiology Alexander’s University Hospital, Sofia, Bulgaria

Aim. The aim of ­this ­study is to ­present the clin­i­cal pic­ture of ­patients ­with cer­e­bel­lo­pon­tine ­angle menin­gio­mas and ana­lyze the ­results of ­their oper­a­tive treat­ment.
Methods. A ret­ro­spec­tive ­study of ­patients ­with cer­e­bel­lo­pon­tine ­angle menin­gio­mas oper­at­ed con­sec­u­tive­ly in our depart­ment ­over an 11-­year peri­od has ­been car­ried out. Data regard­ing ­their clin­i­cal fea­tures, sur­gi­cal treat­ment, mor­bid­ity, mor­tal­ity and out­come ­have ­been ana­lyzed. Forty-­four ­patients ­with cer­e­bel­lo­pon­tine ­angle menin­gio­mas ­were oper­at­ed dur­ing the peri­od 1991-2001 (inter­ven­tion: ­tumor remov­al via the ret­ro­sig­moid sub­oc­cip­i­tal ­approach). Main out­come meas­ures: clin­i­cal con­di­tion, MRI/ CT imag­ing.
Results. The ­median dura­tion of symp­toms ­prior to diag­no­sis was 44.5 ­months. The ­most fre­quent ­initial com­plaints ­were hear­ing ­loss, tin­nit­us and head­ache. Most fre­quent symp­toms and ­signs at pres­en­ta­tion ­were cer­e­bel­lar, fol­lowed by hear­ing ­loss and tri­gem­i­nal ­nerve symp­toms. In 98% of the cas­es the oper­a­tive ­approach ­used was the ret­ro­sig­moid­al sub­oc­cip­i­tal. Total ­tumor remov­al was ­achieved in 55%. After ­total ­tumor remov­al no recur­renc­es ­have ­been ­observed. The mor­tal­ity ­rate was 2%.
Conclusion. The appli­ca­tion of dif­fer­ent clas­sifi­ca­tion ­schemes com­pli­cates the com­par­i­son ­between pub­lished ­series. The out­come ­depends on ­their loca­tion, con­sis­ten­cy, ­size and rela­tion to the sur­round­ing neu­ro­vas­cu­lar struc­tures. In our expe­ri­ence the ret­ro­sig­moid sub­oc­cip­i­tal ­approach is ­most appro­pri­ate for ­their sur­gi­cal treat­ment. It ­offers the pos­sibil­ity to ­remove com­plete­ly ­even ­large menin­gio­mas and ­avoids the ­risk of recur­renc­es.