ArticleNeurosurgical review2025
A single-centre case series of cerebellopontine angle meningioma with intrameatal invasion: surgical outcome and review.
Article in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Cerebellopontine angle meningiomas with intrameatal extension are rare tumors of cerebellopontine angle (CPA) that may mimic vestibular schwannomas, posing significant diagnostic and surgical challenges. Their intimate relationship with the facial and cochlear nerves and sometimes even with lower cranial nerves could make surgical management particularly demanding. We retrospectively reviewed 17 patients who underwent microsurgical resection of CPA meningiomas with intrameatal invasion at San Filippo Neri Hospital, Rome, Italy. Clinical data, radiological features, surgical approach, intraoperative facial nerve monitoring, postoperative outcome, and radiological follow-up were analyzed. The cohort included 12 females and 5 males, with a mean age of 53.8 years (range 37–70). Mean tumor diameter was 2.97 cm (range 2–5 cm). Jugular foramen involvement was observed in 3/17 patients (17.6%). Preoperative symptoms included hearing loss (n = 13), vertigo (n = 8), headache (n = 5), trigeminal neuralgia or paresthesias (n = 4), ataxia (n = 3), and tinnitus (n = 3). All patients were treated via a retrosigmoid craniotomy, with adjuncts including ultrasonic for opening the IAC in all cases, endoscopic assistance in 3, and intraoperative fluorescein in 2. The mean facial nerve stimulation threshold at the end of surgery was 0.12 mA (range 0.01–0.5). Simpson grade I, II or III resection was achieved in all cases; histology confirmed 14 WHO grade I meningiomas and 3 grade III. Clinically, no patient developed new major neurological deficits. Microsurgical removal of CPA meningiomas with intrameatal invasion via the retrosigmoid approach allows for high rates of gross total resection (GTR) and excellent functional outcomes, with minimal morbidity. The systematic use of ultrasonic aspiration, facial nerve monitoring, and, in selected cases, endoscopy or fluorescein, contributed to surgical safety and completeness of resection.
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