Cerebellopontine Angle Meningiomas: A Multi-Institutional Cohort Study

医学 桥小脑角 脑膜瘤 外科 神经血管束 队列 头痛 放射科 磁共振成像 内科学
作者
Neel H. Mehta,Ruchit V. Patel,Saksham Gupta,Harshit Arora,Noah L.A. Nawabi,R.V. Karanth,Samantha Sadler,Lila Medeiros,Rohan Jha,Velina S. Chavarro,Joshua D. Bernstock,Timothy R. Smith,Omar Arnaout
出处
期刊:Neurosurgery [Oxford University Press]
标识
DOI:10.1227/neu.0000000000003258
摘要

BACKGROUND AND OBJECTIVES: Cerebellopontine angle (CPA) meningiomas present challenges given their proximity to neurovascular structures. Postoperative complications and persistent symptoms can debilitate patients, and our ability to predict recovery course remains variable. Here, we examine the presentation, management, and outcomes of patients with CPA meningiomas. METHODS: We retrospectively reviewed CPA meningiomas resected at Mass General Brigham, using descriptive statistics and logistic regression to identify predictors of progression or recurrence. RESULTS: In total, 95 patients were identified (median age 59.1 years, 82.1% female) who presented most commonly with hearing loss (49.5%), ataxia (42.1%), and headaches (29.5%). The retrosigmoid (78.9%) or transmastoid retrosigmoid (17.9%) approaches were most frequently used for resection, with gross total resection (GTR) achieved in 62.1% of patients: Simpson grade 1 (32.6%), grade 2 (17.9%), and grade 3 (11.6%). Smaller tumor size (t = 3.17, P = .002) is associated with GTR. For tumors with intracanalicular invasion, drilling the internal auditory canal (IAC) was also associated with GTR (χ 2 = 21.8, P < .001). Among cases with invasion, GTR was achieved in 88.5% of cases when the IAC was drilled vs 11.8% of cases when the IAC was not drilled. The cranial nerve VII/VIII complex was frequently inferior (45.6%) or superior (19.1%) to the meningioma. Postoperative hearing loss was stable (38.7%) or improved (54.8%) in most of patients at the final clinical follow-up (median: 39.4 months). 25.3% of patients had progression/recurrence, with some difference between World Health Organization grade 1 (median: 3.0 years, IQR: 2.9 years) and World Health Organization grade 2 (median: 1.6 years, IQR: 2.8 years) tumors. After multivariate adjustment, Simpson grade I ( P = .02), Simpson grade II ( P = .01), or being of older age ( P = .003) were associated with lower odds of progression/recurrence. CONCLUSION: GTR remains critical to achieve optimal symptom control and reduce progression/recurrence rates for CPA meningiomas. Drilling the IAC is an important predictor of GTR in tumors with intracanalicular invasion.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
FancyShi发布了新的文献求助10
刚刚
刚刚
1秒前
材料打工人完成签到,获得积分10
1秒前
冷傲菠萝完成签到 ,获得积分10
1秒前
小马甲应助学习痴采纳,获得10
2秒前
Chenyan775199完成签到,获得积分10
2秒前
席冥完成签到,获得积分10
4秒前
cxlhzq发布了新的文献求助10
5秒前
Qiangxianing完成签到,获得积分20
5秒前
qweerrtt完成签到,获得积分10
5秒前
6秒前
啊啊啊完成签到 ,获得积分10
6秒前
SciGPT应助FancyShi采纳,获得10
7秒前
ZXT完成签到 ,获得积分10
7秒前
8秒前
skippy完成签到 ,获得积分10
8秒前
刘科江发布了新的文献求助10
9秒前
Shirley应助活力寒梅采纳,获得10
9秒前
ZUIZUI发布了新的文献求助10
11秒前
文静的晓绿完成签到,获得积分20
12秒前
13秒前
科研小趴菜完成签到,获得积分10
13秒前
14秒前
科研通AI2S应助小号采纳,获得10
15秒前
hello_world完成签到,获得积分10
15秒前
wyw完成签到,获得积分10
17秒前
Singularity应助宋十一采纳,获得10
18秒前
鱼鱼鱼发布了新的文献求助10
18秒前
HHHHHH发布了新的文献求助10
18秒前
18秒前
大个应助坚强的山芙采纳,获得10
19秒前
刘科江完成签到,获得积分10
20秒前
结实的芷文完成签到,获得积分10
20秒前
上官若男应助林荫下的熊采纳,获得10
21秒前
22秒前
22秒前
彭于晏应助复杂的如萱采纳,获得10
22秒前
23秒前
zhang完成签到,获得积分10
23秒前
高分求助中
Sustainability in Tides Chemistry 2800
The Young builders of New china : the visit of the delegation of the WFDY to the Chinese People's Republic 1000
Rechtsphilosophie 1000
Bayesian Models of Cognition:Reverse Engineering the Mind 888
Handbook of Qualitative Cross-Cultural Research Methods 600
Very-high-order BVD Schemes Using β-variable THINC Method 568
Chen Hansheng: China’s Last Romantic Revolutionary 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3137238
求助须知:如何正确求助?哪些是违规求助? 2788358
关于积分的说明 7785777
捐赠科研通 2444399
什么是DOI,文献DOI怎么找? 1299897
科研通“疑难数据库(出版商)”最低求助积分说明 625650
版权声明 601023