Preoperative and postoperative auditory and facial nerve function in cerebellopontine angle meningiomas

Preoperative and postoperative facial nerve and auditory function were reviewed retrospectively in 13 cases of cerebellopontine angle meningiomas. According to their location within the posterior fossa and with special reference to the internal auditory canal, they were classified into a premeatal and a retromeatal group. All the tumors were removed by an otoneurosurgical team by use of a retrosigmoid approach. Postoperative results (1 year after operation) were compared within the two groups with respect to preservation of hearing (normal hearing in 31% and preservation of preoperative hearing in 69% of the cases) and facial nerve function (no or mild postoperative impairment in 69% of the cases). Both preoperative and postoperative impairment of facial nerve and auditory function prevailed in the premeatal group. For preservation of vital vascular and central nervous structures, subtotal resection with consecutive fractionated radiation therapy had to be performed in 30% of the cases. Our results provide substantial evidence that in cerebellopontine angle meningiomas a precise preoperative study of tumor location will assist in improving individual operative strategy and thus postoperative functional results.