Auditory and Facial Nerve Function Following
Surgery for Cerebellopontine Angle Meningiomas
Pete S. Batra, MD; Jose C. Dutra, MD; Richard J. Wiet, MD
To investigate the postoperative auditory and
facial nerve function results after cerebellopontine angle
Retrospective chart review.
Tertiary care referral center.
Twenty-one patients undergoing surgical re-
moval of cerebellopontine angle meningiomas by the se-
nior author (R.J.W.).
Translabyrinthine or retrosigmoid ap-
proach for tumor extirpation.
Main Outcome Measures:
(pure-tone average and speech discrimination score) and
facial (House-Brackmann scale) function within 1 year
Twenty-three operations were performed on 21
patients. Hearing preservation through the retrosigmoid
approach was attempted in 11 patients (48%). Normal hear-
ing (class A) was preserved in 9 of 10 patients. Normal post-
operative facial nerve function (House-Brackmann grade
I) was conserved in 11 (65%) of 17 patients .
the retrosigmoid approach should be used whenever ser-
function can also be preserved in the majority of patients.
Arch Otolaryngol Head Neck Surg. 2002;128:369-374
PPROXIMATELY 10% of all in-
tracranial tumors origi-
nate in the cerebellopon-
tine angle (CPA), with
comprising the majority of tumors in this
Meningiomas are the second most
common neoplasm in the CPA, represent-
ing 10% to 15% of tumors.
They are his-
tologically considered to be benign tu-
mors arising from the arachnoid villi of the
The usual sites of attach-
ment of the posterior fossa meningiomas are
the posterior surface of the petrous bone,
tentorium, clivus, cerebellar convexity, and
foramen magnum, in decreasing order of fre-
According to Nager and Masica,
meningiomas originate in 4 specific loca-
tions in the posterior petrous pyramid: the
internal auditory meatus, jugular fora-
men, region of the geniculate ganglion, and
sulcus of the greater and lesser superficial
petrosal nerves. This may account for the
variability of location of meningiomas and
for their relationship to critical structures.
Clinical manifestations of meningio-
mas are usually otologic or neurologic, sec-
ondary to involvement of contiguous struc-
tures of the posterior fossa. Presenting
symptoms commonly include hearing loss,
imbalance, tinnitus, facial numbness, and
headaches. Less frequently, patients may
complain of trigeminal neuralgia, diplo-
pia, nausea, facial paresis, otalgia, or loss
Indeed, the clinical symptoms of
meningiomas can be very similar to those
of vestibular schwannomas, thus making
the preoperative differentiation between
the 2 neoplasms difficult.