8. U màng não góc cầu - tiểu não trước và sau ống tai trong: chẩn đoán và kết quả phẫu thuật

Abstract

Cerebellopontine angle (CPA) meningiomas are the second most common tumor of the CPA. Depending on the location of tumor attachment to the dura mater, the relationship between the tumor and critical neurovascular structures of the CPA is different. This study assessed the clinical symptoms, imaging and surgical treatments of CPA meningiomas. From August 2020 to August 2022, 33 patients with CPA meningiomas were at Viet Duc Hospital; 27 were females (85%) and 6 (15%) were males. The mean age was 54 ± 12 years. Based on the location of the tumor relative to the internal auditory canal (IAC), there were 16 cases of premeatal (49%) and 17 cases of retromeatal (51%). Compared to the premeatal group, on average, those in the retromeatal group had later time of diagnosis after clinical symptoms (16.5 months vs 9.7 months). The average tumor sizes between the 2 groups were not statistically different, but when there was brainstem compression, the average tumor size of retromeatal group was larger (49mm vs 44mm). The clinical presentations of the retromeatal group were related to the cerebellar symptoms, while symptoms in the premeatal group were all related to trigeminal neuropathy. The percentage of gross-total resection in the premeatal group was 31% and in the retrometal group was 71%. The rates of preserving the facial nerve function in the premeatal group were lower than the retromeatal group (44% vs 82%). Postoperative Karnofsky score of the retromeatal group improved while the score of premeatal group did not change. The meningiomas’ relative location anterior or posterior to the IAC is related to clinical symptoms and correct classification of CPA meningiomas is important in making diagnosis, surgical strategy as well as surgical outcomes.