Cerebellopontine angle tumours: clinico-radiological features and surgical outcome

Abstract

Object. Our aim is to demonstrate the various aspects of clinical-Radiological presentation and surgical Outcome with association to the tumour size concerning cerebellopontine angle (CPA) tumours. Materials and method. This is a prospective study of 40 patients at the Department of Neurosurgery, Jayarogya Group of Hospitals, GRMC Gwalior, M.P. India. All of the patients were pre-operatively evaluated with either non-enhanced and enhanced computerized tomography (CT) or Magnetic-resonance (MR) imaging or both.CPA tumours (predominantly acoustic neuroma) that underwent surgical removal using a suboccipital retro sigmoid approach over a 2-year period (June 2019 to May 2021). Results. There was a female preponderance. The most common presentation was Sensorineural hearing loss (90%) followed by Headache (67.5%). The majority of cases of Vestibular Schwannoma have heterogenous enhancement with cystic component.65% of patients have large (26-40mm) size tumours and facial nerve preservation is 86.4% in medium size tumours (10-25 mm).and Incidence of post-postoperative of facial nerve palsy is more in Giant size tumour (> 40mm) so Positive association between size of lesion and Incidence of Post-operative facial nerve palsy. CSF leak occurs in 6 patients and postoperative Hydrocephalus occur in 2 patients and Mortality occurs in 3 patients. Conclusion. CP angle Tumor was common in middle age group, with the incidence in females slightly more than in males. The majority of lesions were of large size (26-40mm). Most of the patients on admission had a non-serviceable hearing. Heterogeneous enhancement with cystic components was found in most of the lesions. Gross-total excision was one in the majority of cases and vestibular schwannoma was the most common histopathological lesion obtained. Facial nerve palsy was the most complication and as the size of the lesion increased, the possibility of facial nerve palsy also increased post-operatively. Overall mortality is 7.5%.