POSTERIOR-FOSSA MENINGIOMA - SURGICAL STRATEGY

Posterior fossa meningioma is the second most common tumor in the cere bellopontine angle. It has a higher rate of postoperative morbidity an d mortality compared to acoustic neuroma. Forty posterior fossa mening ioma patients managed in our centers were reviewed. Thirty-nine patien ts were managed surgically with 42 surgical procedures. The approaches used were the translabyrinthine approach in 18 patients (43%), the mo dified transcochlear in 11 cases (26%), the petro-occipital transsigmo id in 5 cases (12%), the suboccipital in 4 cases (10%), the petro-occi pital trassigmoid transcervical in 2 cases (5%), the petro-occipital t ranssigmoid transtentorial in 1 case (2%), and a subtemporal transtent orial for another case (2%). Facial nerve anatomical integrity was pre served in 87% of procedures but was interrupted in 5 cases, with 4 of the latter subsequently repaired. Total tumor removal was accomplished in 38 cases. A second-stage total tumor removal is planned for the re maining case. There was only one case of perioperative death and no ca ses of radiological recurrence so far.