Microsurgical treatment of intra-auditory meningioma
10.3760/cma.j.cn115354-20190925-00554
- VernacularTitle:内听道脑膜瘤的显微外科手术治疗
- Author:
Lihua CHEN
1
;
Wenjin CHEN
;
Hongtian ZHANG
;
Kai SUN
;
Ruxiang XU
Author Information
1. 四川省医学科学院 四川省人民医院神经外科，成都 610000
- Keywords:
Intra-auditory;
Meningioma;
Retrosigmoid transmeatal approach;
Cerebello-pontine angle
- From:
Chinese Journal of Neuromedicine
2020;19(3):229-233
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the surgical methods and experiences of intra-auditory meningioma, and discuss the techniques achieving complete resection of intra-auditory meningioma by retrosigmoid transmeatal approach on the basis of function reservation of the facial nerve and auditory nerve.Methods:The clinical data of 4 patients with intra-auditory meningioma confirmed by surgery and pathology in Xuanwu Hospital of Capital Medical University and Army General Hospital of People's Liberation Army from January 1998 to December 2018 were retrospectively analyzed. All these 4 patients accepted enlargment of the posterior wall of the internal auditory channel via retrosigmoid transmeatal approach to remove the tumors. The electro-audiogram, surgical records, discharge records and follow-up records were noted.Results:Total resection was achieved in all 4 patients; one was derived from the cerebral dura mater of the outside wall of the internal auditory canal, obtaining radical excision (Simpson grading I resection); the other three were derived from the cerebral dura mater of the internal auditory canal, and the epidural adhesion extended to the ventral internal auditory canal, only receiving Simpson grading II resection. The facial nerve and cochlear nerve in three patients were separated and protected by dissection; while the vestibular nerve and cochlear nerve in the left one patient were not found, and only the facial nerve was dissected and preserved. Two patients with preoperative hearing grading H2 and H3 were able to retain effective hearing after surgery, with postoperative hearing grading H3 and H4, respectively; and the other two patients had postoperative hearing grading H5. Postoperative Karnofsky Performance Scale (KPS) scores were 90 in 3 patients and 70 in one patient. There was no perioperative death.Conclusions:Retrosigmoid transmeatal approach is ideal approach for resection of the intra-auditory meningioma. Surgical excision of intra-auditory meningioma should accept the premise of protecting the facial auditory nerve and aim at extensive resection of tumors, including the dura and bone involved by tumors, so as to reduce the chance of recurrence; and it is necessary to open the width of intra-auditory.
