MENINGIOMAS INTRINSIC TO THE GENICULATE GANGLION

Objective: To present the clinical, surgical and histopathological man ifestations of meningioma intrinsic to the geniculate ganglion. Study Design: Retrospective study of outcome. Setting: Three private tertiar y and one university (otology/neurotology) referral centers. Patients: Six patients with cranial nerve VII paresis underwent magnetic resona nce imaging and/or high-resolution computed tomography for subsequentl y histologically proven intrinsic meningioma of the geniculate ganglio n. An additional six cases were identified in the literature. Most pat ients were female and ranged in age from 5 to 40 years. Intervention: Total tumor removal via middle fossa and mastoid exposures followed by cable graft VIT-VII neuroanastomosis. Main Outcome Measure: Meningiom a can occur intrinsic to the geniculate ganglion and produces gradual VIIth nerve paresis as its first symptom. Other sites of predilection may occur extrinsically within the temporal bone or along intracranial venous sinuses at sites of arachnoid villi. Results: Hearing was main tained in each patient, and postoperative House-Brackmann grade III-V facial nerve function was achieved. Conclusions: Intrinsic meningiomas of the geniculate ganglion rarely occur. However, this entity should be included in the differential diagnosis of a slowly progressive VIIt h nerve paresis, especially in young females. Surgical removal and cab le graft VII-VII neuroanastomosis is the treatment of choice. Longterm follow-up should be maintained because of the potential for von Reckl inghausen's disease.