Petrous meningiomas: a review of seventeen cases

Seventeen patients with petrous meningiomas managed at St. Michael's Hospital, during the years 1973-1987, were retrospectively reviewed. There were 15 females and 2 males; their ages ranged from 42 to 68 years (mean age: 53 years). The clinical presentation most commonly included headache and eighth cranial nerve dysfunction; the average duration of symptoms was 6 years (3 month-27 years). Computed tomography was performed in 15 cases. The mean tumour size was 2.5 centimeters (0.5-4 cm). The most common site of tumour origin was at or medial to the porus acousticus. Meningioma was suspected preoperatively in 10 of the 15 patients who had preoperative CT scans. Complete excision was obtained in 12 cases. There were no operative deaths after initial resections. Postoperative morbidity included worsening of pre-existing hearing loss in six patients, transient facial nerve palsies in six, permanent facial nerve palsies in four and new facial or corneal hypesthesia in three. Two patients developed cerebrospinal fluid fistulae. Tumour recurrence occurred into two patients in whom a complete resection was anticipated. Also, in two patients with incompletely resected tumours second operations were required. Fourteen patients are alive, 13 of whom care for themselves independently. The average follow-up was 5 years (6 months-9 years). It seems appropriate to recommend initial radical surgical excision of these benign tumours, where possible, in order to prevent tumour recurrence.