Microsurgical treatment for large and giant meningiomas of the cerebellopontine angle

Objective To explore the surgical approach and microsurgical technique for treating large and giant meningiomas of the cerebellopontine angle(CPA). Methods Twenty-eight patients with CPA large and giant meningiomas treated with microneurosurgery were analyzed retrospectively.19 cases were used by suboccipital retrosigmoidal approach,3 cases were used by temporal-occipital presigmoid approach,temporal-occipital subtemporal tentorial approach was used in 4 cases and temporal-occipital combined supra-infratentorial approach in 2 cases. Results Twenty-two patients received total removal (Simpson Ⅰ,Ⅱ),the total removal rate was 78.6%.No patient died after the operation.25 patients howed condition improved or persisted.26 patients were followed up for six months to four years and 23 (88.5%) patients could lived by themselves.2 (7.7%) patients developed recurrence. Conclusion It is possible to ideally remove the cerebellopontine angle tumor and inprove the patient’s life quality by choosing the adequate approach rationally,managing and protecting the vessels,nerves and brain stem carefully through microsurgical technique.