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Endoscopic Resection of a Cerebellopontine Angle Meningioma via a Retrosigmoid Approach
A variety of lesions may arise within the cerebellopontine angle (CPA). Schwannomas and meningiomas are most commonly found in this location. Imaging characteristics of meningiomas include hyperdensity on head computed tomography (CT) and avid contrast enhancement on T1-weighted postcontrast magneti...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Georg Thieme Verlag KG
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534693/ https://www.ncbi.nlm.nih.gov/pubmed/31143606 http://dx.doi.org/10.1055/s-0039-1677855 |
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author | Hitti, Frederick Luke Lee, John Y.K. |
author_facet | Hitti, Frederick Luke Lee, John Y.K. |
author_sort | Hitti, Frederick Luke |
collection | PubMed |
description | A variety of lesions may arise within the cerebellopontine angle (CPA). Schwannomas and meningiomas are most commonly found in this location. Imaging characteristics of meningiomas include hyperdensity on head computed tomography (CT) and avid contrast enhancement on T1-weighted postcontrast magnetic resonance imaging (MRI). Here, we present the case of a 49-year-old woman with enlarging right CPA meningioma. The patient reported mild hearing loss on the right but her neurological exam was otherwise benign. Since the lesion was enlarging and symptomatic, the patient was offered resection of the mass for diagnosis and treatment via an endoscopic retrosigmoid approach. We provide a video that illustrates the steps taken to resect this mass endoscopically. After cerebrospinal fluid (CSF) was drained to achieve brain relaxation, the tumor was visualized. The tumor had a rich vascular supply and had the appearance of a typical meningioma. The bipolar was used to cauterize the tumor's vascular supply. The tumor capsule was then opened with the microscissors. The round knife, suction, and ultrasonic tissue debrider were used to debulk the tumor. After internal debulking of the tumor, the capsule was dissected off the cerebellum and mobilized. A combination of blunt and sharp dissection was done to free the tumor capsule from the adjacent structures. Inferiorly, the lower cranial nerves were visualized. Tissue pathology confirmed a diagnosis of grade I meningioma. A gross total resection was achieved and the patient remained neurologically stable, postoperatively. Furthermore, T1-weighted postcontrast brain MRI, 1 year after surgery, showed no residual. The link to the video can be found at: https://youtu.be/X9c_inLp-So . |
format | Online Article Text |
id | pubmed-6534693 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Georg Thieme Verlag KG |
record_format | MEDLINE/PubMed |
spelling | pubmed-65346932020-06-01 Endoscopic Resection of a Cerebellopontine Angle Meningioma via a Retrosigmoid Approach Hitti, Frederick Luke Lee, John Y.K. J Neurol Surg B Skull Base A variety of lesions may arise within the cerebellopontine angle (CPA). Schwannomas and meningiomas are most commonly found in this location. Imaging characteristics of meningiomas include hyperdensity on head computed tomography (CT) and avid contrast enhancement on T1-weighted postcontrast magnetic resonance imaging (MRI). Here, we present the case of a 49-year-old woman with enlarging right CPA meningioma. The patient reported mild hearing loss on the right but her neurological exam was otherwise benign. Since the lesion was enlarging and symptomatic, the patient was offered resection of the mass for diagnosis and treatment via an endoscopic retrosigmoid approach. We provide a video that illustrates the steps taken to resect this mass endoscopically. After cerebrospinal fluid (CSF) was drained to achieve brain relaxation, the tumor was visualized. The tumor had a rich vascular supply and had the appearance of a typical meningioma. The bipolar was used to cauterize the tumor's vascular supply. The tumor capsule was then opened with the microscissors. The round knife, suction, and ultrasonic tissue debrider were used to debulk the tumor. After internal debulking of the tumor, the capsule was dissected off the cerebellum and mobilized. A combination of blunt and sharp dissection was done to free the tumor capsule from the adjacent structures. Inferiorly, the lower cranial nerves were visualized. Tissue pathology confirmed a diagnosis of grade I meningioma. A gross total resection was achieved and the patient remained neurologically stable, postoperatively. Furthermore, T1-weighted postcontrast brain MRI, 1 year after surgery, showed no residual. The link to the video can be found at: https://youtu.be/X9c_inLp-So . Georg Thieme Verlag KG 2019-06 2019-02-26 /pmc/articles/PMC6534693/ /pubmed/31143606 http://dx.doi.org/10.1055/s-0039-1677855 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Hitti, Frederick Luke Lee, John Y.K. Endoscopic Resection of a Cerebellopontine Angle Meningioma via a Retrosigmoid Approach |
title | Endoscopic Resection of a Cerebellopontine Angle Meningioma via a Retrosigmoid Approach |
title_full | Endoscopic Resection of a Cerebellopontine Angle Meningioma via a Retrosigmoid Approach |
title_fullStr | Endoscopic Resection of a Cerebellopontine Angle Meningioma via a Retrosigmoid Approach |
title_full_unstemmed | Endoscopic Resection of a Cerebellopontine Angle Meningioma via a Retrosigmoid Approach |
title_short | Endoscopic Resection of a Cerebellopontine Angle Meningioma via a Retrosigmoid Approach |
title_sort | endoscopic resection of a cerebellopontine angle meningioma via a retrosigmoid approach |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534693/ https://www.ncbi.nlm.nih.gov/pubmed/31143606 http://dx.doi.org/10.1055/s-0039-1677855 |
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