Experiences in the management of cerebellopontine angle tumour: an analysis of 64 cases.

The surgical aspects of 64 consecutive cases of cerebellopontine angle tumours treated from January 1983 to December 1988 are reviewed. Nearly all of the procedures were done through a small suboccipital craniectomy. Two patients underwent a combined subtemporal- suboccipital approach. A stage-operation was performed on three patients harbouring a large to giant-size acoustic neuroma. The most common sign was loss of corneal reflex (29%). Hearing loss was present in 33 patients (51%). Trigeminal neuralgia occurred in 13 patients (20%) on the affected side. Hemifacial spasm was present in one patient with a 2-cm meningioma. The tumour pathology comprised of 37 acoustic neuromas, 16 meningiomas, 5 epidermoid cysts, 3 trigeminal neuromas, 1 metastatic adenocarcinoma, 1 facial neuroma, and 1 tuberculoma. Anatomic continuity of the facial nerve was preserved in 40 patients (66%). Operative mortality rate in this series was three (4.7%). None of the patients has had other further significant neurological deficits postoperatively. Most of our patients were in good condition after the operative procedures.