Surgical Management of Cerbellopontine Angle Tumors - Experience from a Tertiary Care Hospital of Peshawar

Abstract

Objectives: to determine the surgical outcome (clinical improvement and surgical excision) of CP angle tumors and its management in a hospital based study. Study design and setting: This descriptive case series study was carried out in the Department of Neurosurgery Prime Teaching hospital Peshawar from Jan 2018 to 30th August 2022. Methodology: All patients with CP angle disorders were included in the study irrespective of age and gender. Patients with pineal tumor and posterior fossa abscess were excluded. Results: A total of 48 patients were enrolled with 26(54.2%) males and 22(45.8%) females. The mean age with standard deviation of patients was 42+ 9 years. The frequency of CP angle disorders were; Vestibular Schwannoma (Acoustic Neuroma) 31(64.6%), CP Angle Meningioma 8 (16.7%), Vestibular Schwannoma with Hydrocephalus 6(12.5%) and Epidermoid cyst 3(6.3%). 39(81.3%) of the patients were managed through Microsurgical Retrosigmoid Craniectomy, 6(12.5%) via Ventriculo-Peritoneal Shunt and 3(6.3%) were conservatively managed. Eight patients were expired during the follow up. The mean size of tumor was 3.2cm. There was no statistically significant association of gender and age with outcome/mortality in CP angle pathologies (p-0.195, 0.219 respectively). In 11 cases post-operative complications were recorded. 6(12.5%) cases were reported with facial Nerve palsy. Conclusion: Vestibular Schwannoma (Acoustic Neuroma), CP Angle Meningioma, and Vestibular Schwannoma with Hydrocephalus are most common CP Angle pathologies in our set upThere is no statistically significant association of morbidity and mortality of CP angle tumors with age and gender. Facial nerve palsy was well managed with facial hypoglossal anastomosis and torsorraphy.