{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T23:49:25Z","timestamp":1792108165878,"version":"4.4.0"},"reference-count":80,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2013,12]]},"abstract":"\n Object<\/jats:title>\n Tumors of the cerebellopontine angle (CPA) have always proven difficult for neurosurgeons to optimally manage. Studies investigating the natural history and treatment of vestibular schwannomas have dominated the literature in this regard. Distinguishing meningiomas from schwannomas in this location carries particular importance as each tumor type has certain prognostic and surgical considerations. In this study, the authors have characterized the outcomes of 34 patients surgically treated for CPA meningiomas and have investigated various factors that may affect postoperative neurological function.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The medical records of patients with CPA meningiomas who underwent surgery from 2005 to 2013 at the Duke University Health System were reviewed. Various patient, clinical, and tumor data were gathered from the medical records including patient demographics, pre- and postoperative neurological examinations, duration of symptoms, procedural details, tumor pathology and size, and treatment characteristics. Differences in continuous variables were then analyzed using the Student t-test while categorical variables were evaluated using the chi-square test.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 34 patients underwent surgical treatment for CPA meningiomas during the 8-year period. Jugular foramen invasion was seen in 17.6% of tumors, with nearly half (41.2%) extending into the internal acoustic canal. The most common presenting symptom was hearing loss (58.8%), followed by headache (52.9%) and facial numbness\/pain (50.0%). The most common cranial nerve (CN) affected was CN X (11.8%), followed by CNs VI and VII (5.9%). Postoperatively, no patients experienced a decrease in hearing, with only 5.9% of patients experiencing facial nerve palsies. Patients with tumors larger than 3 cm had a significantly higher incidence of permanent CN deficits than those with smaller tumors (45.5% vs 5.9%, respectively; p = 0.011). Also, tumor extension into the jugular foramen was associated with the occurrence of lower CN deficits, none of which occurred in tumors without jugular foramen invasion. Internal acoustic canal tumor extension was not seen to be associated with postoperative complications or CN deficits.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Meningiomas of the CPA are challenging lesions to treat surgically. However, the risk of facial palsy and hearing loss is significantly lower when compared with vestibular schwannomas. Novel methods for preoperative differentiation are needed to appropriately counsel patients on surgical risks. Also, due to the significant potential for neurological deficits, further studies are needed to investigate the utility of radiotherapy for these lesions.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2013.10.focus13367","type":"journal-article","created":{"date-parts":[[2013,12,1]],"date-time":"2013-12-01T03:33:23Z","timestamp":1385868803000},"page":"E10","source":"Crossref","is-referenced-by-count":56,"title":["Cerebellopontine angle meningiomas: postoperative outcomes in a modern cohort"],"prefix":"10.3171","volume":"35","author":[{"given":"Vijay","family":"Agarwal","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjith","family":"Babu","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Grier","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owoicho","family":"Adogwa","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Back","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan H.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanori","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cory","family":"Adamson","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, and"},{"name":"Department of Neurobiology, Duke University Medical Center; and"},{"name":"Neurosurgery Section, Durham VA Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0350010","series-title":"Operative Atlas of Meningiomas","author":"Al-Mefty","year":"1998"},{"key":"b2-0350010","series-title":"Laryngoscope","first-page":"1043","article-title":"Individualizing hearing preservation in acoustic neuroma surgery","volume":"107","author":"Arriaga","year":"1997"},{"key":"b3-0350010","series-title":"Otol Neurotol","first-page":"234","article-title":"Hearing preservation and facial nerve outcomes in vestibular schwannoma surgery: results using the middle cranial fossa approach","volume":"27","author":"Arts","year":"2006"},{"key":"b4-0350010","series-title":"J Neurosurg","first-page":"121","article-title":"Vestibular schwannomas in the modern era: epidemiology, treatment trends, and disparities in management. Clinical article","volume":"119","author":"Babu","year":"2013"},{"key":"b5-0350010","series-title":"J Neurosurg","first-page":"1014","article-title":"Meningiomas of the posterior petrous bone: functional outcome after microsurgery","volume":"100","author":"Bassiouni","year":"2004"},{"key":"b6-0350010","series-title":"Neurosurg Clin N Am","first-page":"331","article-title":"Surgical approaches and complications in the removal of vestibular schwannomas","volume":"19","author":"Bennett","year":"2008"},{"key":"b7-0350010","series-title":"J Clin Neurosci","first-page":"521","article-title":"Current management of acoustic neuromas: review of surgical approaches and outcomes","volume":"7","author":"Briggs","year":"2000"},{"key":"b8-0350010","series-title":"Acta Otolaryngol","first-page":"1249","article-title":"Perioperative complications after translabyrinthine removal of large or giant vestibular schwannoma: outcomes for 123 patients","volume":"130","author":"Charpiot","year":"2010"},{"key":"b9-0350010","series-title":"Laryngoscope","first-page":"681","article-title":"Vestibular schwannoma surgery outcomes: our multidisciplinary experience in 400 cases over 17 years","volume":"114","author":"Darrouzet","year":"2004"},{"key":"b10-0350010","series-title":"ANZ J Surg","first-page":"893","article-title":"Facial nerve function and hearing preservation after retrosigmoid excision of vestibular schwannoma: Christchurch Hospital experience with 97 patients","volume":"75","author":"Darwish","year":"2005"},{"key":"b11-0350010","series-title":"Neurosurgery","first-page":"1282","article-title":"Venous air embolism in sitting and supine patients undergoing vestibular schwannoma resection","volume":"42","author":"Duke","year":"1998"},{"key":"b12-0350010","series-title":"Rev Laryngol Otol Rhinol (Bord)","first-page":"45","article-title":"[Acoustic neuroma surgery. Results and complications in 348 cases.]","volume":"124","author":"En\u00e9e","year":"2003"},{"key":"b13-0350010","series-title":"Ann Otol Rhinol Laryngol","first-page":"454","article-title":"Middle cranial fossa acoustic neuroma excision: results and complications","volume":"95","author":"Gantz","year":"1986"},{"key":"b14-0350010","series-title":"Neurosurgery","first-page":"50","article-title":"Acoustic neuromas: results of current surgical management","volume":"41","author":"Gormley","year":"1997"},{"key":"b15-0350010","series-title":"Otolaryngol Head Neck Surg","first-page":"906","article-title":"Facial nerve outcomes in middle cranial fossa vs translabyrinthine approaches","volume":"133","author":"Isaacson","year":"2005"},{"key":"b16-0350010","series-title":"Neurol India","first-page":"41","article-title":"Surgery of vestibular schwannomas: an institutional experience","volume":"53","author":"Jain","year":"2005"},{"key":"b17-0350010","series-title":"J Clin Neurosci","first-page":"755","article-title":"Clinical and surgical considerations for cerebellopontine angle meningiomas","volume":"18","author":"Kane","year":"2011"},{"key":"b18-0350010","series-title":"World Neurosurg","first-page":"114","article-title":"Angiographic classification of tumor attachment of meningiomas at the cerebellopontine angle","volume":"75","author":"Kunii","year":"2011"},{"key":"b19-0350010","series-title":"Skull Base","first-page":"443","article-title":"Concurrent vestibular schwannoma and meningioma mimicking a single cerebellopontine angle tumor","volume":"19","author":"Kutz","year":"2009"},{"key":"b20-0350010","series-title":"Otolaryngol Head Neck Surg","first-page":"949","article-title":"Combined transtemporal access for large (>3 cm) meningiomas of the cerebellopontine angle","volume":"134","author":"Leonetti","year":"2006"},{"key":"b21-0350010","series-title":"Otolaryngol Head Neck Surg","first-page":"396","article-title":"Complications of translabyrinthine vs. suboccipital approach for acoustic tumor surgery","volume":"99","author":"Mangham","year":"1988"},{"key":"b22-0350010","series-title":"J Laryngol Otol","first-page":"120","article-title":"Facial nerve outcomes in functional vestibular schwannoma surgery: less than total tumour excision significantly improves results","volume":"126","author":"Martin","year":"2012"},{"key":"b23-0350010","series-title":"J Neurosurg","first-page":"337","article-title":"Hearing preservation in acoustic neuroma surgery: importance of adhesion between the cochlear nerve and the tumor","volume":"97","author":"Moriyama","year":"2002"},{"key":"b24-0350010","series-title":"Neurosurgery","first-page":"654","article-title":"Vestibular schwannoma: surgery or gamma knife radiosurgery? A prospective, nonrandomized study","volume":"64","author":"Myrseth","year":"2009"},{"key":"b25-0350010","series-title":"Neurosurgery","first-page":"77","article-title":"Facial and cochlear nerve function after surgery of cerebellopontine angle meningiomas","volume":"57","author":"Nakamura","year":"2005"},{"issue":"2 Suppl Operative","key":"b26-0350010","series-title":"Neurosurgery","first-page":"ons103","article-title":"Contemporary surgical management of vestibular schwannomas: analysis of complications and lessons learned over the past decade","volume":"72","author":"Nonaka","year":"2013"},{"key":"b27-0350010","series-title":"Neurosurgery","first-page":"77","article-title":"Patient outcomes after vestibular schwannoma management: a prospective comparison of microsurgical resection and stereotactic radiosurgery","volume":"59","author":"Pollock","year":"2006"},{"key":"b28-0350010","series-title":"J Neurosurg","first-page":"17","article-title":"Meningiomas of the cerebellopontine angle with extension into the internal auditory canal","volume":"102","author":"Roser","year":"2005"},{"key":"b29-0350010","series-title":"J Neurosurg","first-page":"200","article-title":"Vascular complications of vestibular schwannoma surgery: a comparison of the suboccipital retrosigmoid and translabyrinthine approaches","volume":"105","author":"Sade","year":"2006"},{"key":"b30-0350010","series-title":"Neurosurgery","first-page":"640","article-title":"Critical assessment of operative approaches for hearing preservation in small acoustic neuroma surgery: retrosigmoid vs middle fossa approach","volume":"67","author":"Sameshima","year":"2010"},{"key":"b31-0350010","series-title":"Otol Neurotol","first-page":"379","article-title":"Perioperative complications in acoustic neuroma (vestibular schwannoma) surgery","volume":"25","author":"Sanna","year":"2004"},{"key":"b32-0350010","series-title":"J Neurosurg","first-page":"500","article-title":"Cerebellopontine angle meningiomas. Microsurgical excision and follow-up results","volume":"60","author":"Sekhar","year":"1984"},{"key":"b33-0350010","series-title":"J Neurosurg","first-page":"588","article-title":"Gamma Knife surgery for skull base meningiomas. Clinical article","volume":"116","author":"Starke","year":"2012"},{"key":"b34-0350010","series-title":"J Neurosurg","first-page":"367","article-title":"Beyond audiofacial morbidity after vestibular schwannoma surgery. Clinical article","volume":"114","author":"Sughrue","year":"2011"},{"key":"b35-0350010","series-title":"Br J Neurosurg","first-page":"59","article-title":"Meningiomas of the cerebellopontine angle. A report of 41 cases","volume":"10","author":"Thomas","year":"1996"},{"key":"b36-0350010","series-title":"Neurol Med Chir (Tokyo)","first-page":"482","article-title":"Usefulness of PRESTO magnetic resonance imaging for the differentiation of schwannoma and meningioma in the cerebellopontine angle","volume":"53","author":"Tomogane","year":"2013"},{"key":"b37-0350010","series-title":"Surg Neurol","first-page":"439","article-title":"Meningiomas of the cerebellopontine angle","volume":"53","author":"Voss","year":"2000"},{"key":"b38-0350010","series-title":"J Neurosurg","first-page":"845","article-title":"Hearing preservation in surgery for large vestibular schwannomas. Clinical article","volume":"111","author":"Wanibuchi","year":"2009"},{"key":"b39-0350010","series-title":"Neurosurgery","first-page":"577","article-title":"Proton beam radiosurgery for vestibular schwannoma: tumor control and cranial nerve toxicity","volume":"53","author":"Weber","year":"2003"},{"key":"b40-0350010","series-title":"J Neurosurg","first-page":"400","article-title":"Decision analysis of treatment options for vestibular schwannoma. Clinical article","volume":"114","author":"Whitmore","year":"2011"},{"key":"b1-0350010","series-title":"Operative Atlas of Meningiomas","author":"Al-Mefty","year":"1998"},{"key":"b2-0350010","series-title":"Laryngoscope","first-page":"1043","article-title":"Individualizing hearing preservation in acoustic neuroma surgery","volume":"107","author":"Arriaga","year":"1997"},{"key":"b3-0350010","series-title":"Otol Neurotol","first-page":"234","article-title":"Hearing preservation and facial nerve outcomes in vestibular schwannoma surgery: results using the middle cranial fossa approach","volume":"27","author":"Arts","year":"2006"},{"key":"b4-0350010","series-title":"J Neurosurg","first-page":"121","article-title":"Vestibular schwannomas in the modern era: epidemiology, treatment trends, and disparities in management. Clinical article","volume":"119","author":"Babu","year":"2013"},{"key":"b5-0350010","series-title":"J Neurosurg","first-page":"1014","article-title":"Meningiomas of the posterior petrous bone: functional outcome after microsurgery","volume":"100","author":"Bassiouni","year":"2004"},{"key":"b6-0350010","series-title":"Neurosurg Clin N Am","first-page":"331","article-title":"Surgical approaches and complications in the removal of vestibular schwannomas","volume":"19","author":"Bennett","year":"2008"},{"key":"b7-0350010","series-title":"J Clin Neurosci","first-page":"521","article-title":"Current management of acoustic neuromas: review of surgical approaches and outcomes","volume":"7","author":"Briggs","year":"2000"},{"key":"b8-0350010","series-title":"Acta Otolaryngol","first-page":"1249","article-title":"Perioperative complications after translabyrinthine removal of large or giant vestibular schwannoma: outcomes for 123 patients","volume":"130","author":"Charpiot","year":"2010"},{"key":"b9-0350010","series-title":"Laryngoscope","first-page":"681","article-title":"Vestibular schwannoma surgery outcomes: our multidisciplinary experience in 400 cases over 17 years","volume":"114","author":"Darrouzet","year":"2004"},{"key":"b10-0350010","series-title":"ANZ J Surg","first-page":"893","article-title":"Facial nerve function and hearing preservation after retrosigmoid excision of vestibular schwannoma: Christchurch Hospital experience with 97 patients","volume":"75","author":"Darwish","year":"2005"},{"key":"b11-0350010","series-title":"Neurosurgery","first-page":"1282","article-title":"Venous air embolism in sitting and supine patients undergoing vestibular schwannoma resection","volume":"42","author":"Duke","year":"1998"},{"key":"b12-0350010","series-title":"Rev Laryngol Otol Rhinol (Bord)","first-page":"45","article-title":"[Acoustic neuroma surgery. Results and complications in 348 cases.]","volume":"124","author":"En\u00e9e","year":"2003"},{"key":"b13-0350010","series-title":"Ann Otol Rhinol Laryngol","first-page":"454","article-title":"Middle cranial fossa acoustic neuroma excision: results and complications","volume":"95","author":"Gantz","year":"1986"},{"key":"b14-0350010","series-title":"Neurosurgery","first-page":"50","article-title":"Acoustic neuromas: results of current surgical management","volume":"41","author":"Gormley","year":"1997"},{"key":"b15-0350010","series-title":"Otolaryngol Head Neck Surg","first-page":"906","article-title":"Facial nerve outcomes in middle cranial fossa vs translabyrinthine approaches","volume":"133","author":"Isaacson","year":"2005"},{"key":"b16-0350010","series-title":"Neurol India","first-page":"41","article-title":"Surgery of vestibular schwannomas: an institutional experience","volume":"53","author":"Jain","year":"2005"},{"key":"b17-0350010","series-title":"J Clin Neurosci","first-page":"755","article-title":"Clinical and surgical considerations for cerebellopontine angle meningiomas","volume":"18","author":"Kane","year":"2011"},{"key":"b18-0350010","series-title":"World Neurosurg","first-page":"114","article-title":"Angiographic classification of tumor attachment of meningiomas at the cerebellopontine angle","volume":"75","author":"Kunii","year":"2011"},{"key":"b19-0350010","series-title":"Skull Base","first-page":"443","article-title":"Concurrent vestibular schwannoma and meningioma mimicking a single cerebellopontine angle tumor","volume":"19","author":"Kutz","year":"2009"},{"key":"b20-0350010","series-title":"Otolaryngol Head Neck Surg","first-page":"949","article-title":"Combined transtemporal access for large (>3 cm) meningiomas of the cerebellopontine angle","volume":"134","author":"Leonetti","year":"2006"},{"key":"b21-0350010","series-title":"Otolaryngol Head Neck Surg","first-page":"396","article-title":"Complications of translabyrinthine vs. suboccipital approach for acoustic tumor surgery","volume":"99","author":"Mangham","year":"1988"},{"key":"b22-0350010","series-title":"J Laryngol Otol","first-page":"120","article-title":"Facial nerve outcomes in functional vestibular schwannoma surgery: less than total tumour excision significantly improves results","volume":"126","author":"Martin","year":"2012"},{"key":"b23-0350010","series-title":"J Neurosurg","first-page":"337","article-title":"Hearing preservation in acoustic neuroma surgery: importance of adhesion between the cochlear nerve and the tumor","volume":"97","author":"Moriyama","year":"2002"},{"key":"b24-0350010","series-title":"Neurosurgery","first-page":"654","article-title":"Vestibular schwannoma: surgery or gamma knife radiosurgery? A prospective, nonrandomized study","volume":"64","author":"Myrseth","year":"2009"},{"key":"b25-0350010","series-title":"Neurosurgery","first-page":"77","article-title":"Facial and cochlear nerve function after surgery of cerebellopontine angle meningiomas","volume":"57","author":"Nakamura","year":"2005"},{"issue":"2 Suppl Operative","key":"b26-0350010","series-title":"Neurosurgery","first-page":"ons103","article-title":"Contemporary surgical management of vestibular schwannomas: analysis of complications and lessons learned over the past decade","volume":"72","author":"Nonaka","year":"2013"},{"key":"b27-0350010","series-title":"Neurosurgery","first-page":"77","article-title":"Patient outcomes after vestibular schwannoma management: a prospective comparison of microsurgical resection and stereotactic radiosurgery","volume":"59","author":"Pollock","year":"2006"},{"key":"b28-0350010","series-title":"J Neurosurg","first-page":"17","article-title":"Meningiomas of the cerebellopontine angle with extension into the internal auditory canal","volume":"102","author":"Roser","year":"2005"},{"key":"b29-0350010","series-title":"J Neurosurg","first-page":"200","article-title":"Vascular complications of vestibular schwannoma surgery: a comparison of the suboccipital retrosigmoid and translabyrinthine approaches","volume":"105","author":"Sade","year":"2006"},{"key":"b30-0350010","series-title":"Neurosurgery","first-page":"640","article-title":"Critical assessment of operative approaches for hearing preservation in small acoustic neuroma surgery: retrosigmoid vs middle fossa approach","volume":"67","author":"Sameshima","year":"2010"},{"key":"b31-0350010","series-title":"Otol Neurotol","first-page":"379","article-title":"Perioperative complications in acoustic neuroma (vestibular schwannoma) surgery","volume":"25","author":"Sanna","year":"2004"},{"key":"b32-0350010","series-title":"J Neurosurg","first-page":"500","article-title":"Cerebellopontine angle meningiomas. Microsurgical excision and follow-up results","volume":"60","author":"Sekhar","year":"1984"},{"key":"b33-0350010","series-title":"J Neurosurg","first-page":"588","article-title":"Gamma Knife surgery for skull base meningiomas. Clinical article","volume":"116","author":"Starke","year":"2012"},{"key":"b34-0350010","series-title":"J Neurosurg","first-page":"367","article-title":"Beyond audiofacial morbidity after vestibular schwannoma surgery. Clinical article","volume":"114","author":"Sughrue","year":"2011"},{"key":"b35-0350010","series-title":"Br J Neurosurg","first-page":"59","article-title":"Meningiomas of the cerebellopontine angle. A report of 41 cases","volume":"10","author":"Thomas","year":"1996"},{"key":"b36-0350010","series-title":"Neurol Med Chir (Tokyo)","first-page":"482","article-title":"Usefulness of PRESTO magnetic resonance imaging for the differentiation of schwannoma and meningioma in the cerebellopontine angle","volume":"53","author":"Tomogane","year":"2013"},{"key":"b37-0350010","series-title":"Surg Neurol","first-page":"439","article-title":"Meningiomas of the cerebellopontine angle","volume":"53","author":"Voss","year":"2000"},{"key":"b38-0350010","series-title":"J Neurosurg","first-page":"845","article-title":"Hearing preservation in surgery for large vestibular schwannomas. Clinical article","volume":"111","author":"Wanibuchi","year":"2009"},{"key":"b39-0350010","series-title":"Neurosurgery","first-page":"577","article-title":"Proton beam radiosurgery for vestibular schwannoma: tumor control and cranial nerve toxicity","volume":"53","author":"Weber","year":"2003"},{"key":"b40-0350010","series-title":"J Neurosurg","first-page":"400","article-title":"Decision analysis of treatment options for vestibular schwannoma. 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