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Year : 2020  |  Volume : 4  |  Issue : 1  |  Page : 34-41

Surgical management of cerebellopontine angle tumors

Department of Neurosurgery, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt

Correspondence Address:
MD, PhD, IFAANS Gasser Hasan Rabee Al Shyal
Department of Neurosurgery, Faculty of Medicine for Girls, Al- Azhar University, Abbassyia St. Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjamf.sjamf_109_19

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Background Even though there is a high prevalence of tumors within the cerebellopontine angle (CPA), surgical management in this region remains a major obstacle owing to the critical neurovascular structures passing the CPA and constringed surgical access, with displayed complication rates. Aims The current study was conducted to evaluate the various clinical and radiological modalities that are used for diagnosis of CPA tumors and planning of their surgeries. Additionally, it aimed to compare the various surgical strategies that have been used for excision of CPA tumors along with the assessment of cerebrospinal fluid diversion role in CPA surgery. Patients and methods Patients with CPA tumor who have been diagnosed and treated surgically in 2-year interval between October 2017 and October 2019 were eligible for inclusion in the study. Surgeries were done via retrosigmoid or middle fossa approaches. Results Patients experienced considerable improvement of the clinical symptoms especially intracranial tension, particularly those subordinated to preoperative shunt. Subsequent to that patients revealed dramatic improvement of the tinnitus, headache, vertigo, ataxia, and unsteadiness of gait after surgery. In addition, facial palsy was the most predominant complication succeeded by cerebellar ataxia, hematoma at the tumor bed, left-side hemiplegia, local wound infection, and meningitis. Conclusion Retrosigmoid and middle fossa approaches accomplished significant outcome among patients with CPA tumors, counterpart hearing symptoms, bulbar affection, facial weakness, and cerebellar manifestations. Preoperative V-P shunt procedure improved noticeably the manifestations of increased intracranial tension.

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