Clinical features and outcomes in patients with non-acoustic cerebellopontine angle tumours

Objectives-Non-acoustic tumours of the cerebellopontine angle differ from v estibular schwannomas in their prevalence, clinical features, operative man agement, and surgical outcome. These features were studied in patients pres enting to the regional neuro-otological unit. Methods-A retrospective analysis of clinical notes identified 42 patients w ith non-acoustic tumours of the cerebellopontine angle. Data were extracted regarding presenting clinical features, histopathological data after surgi cal resection, surgical morbidity and mortality, and clinical outcome (mean 32 months follow up). Results-The study group comprised 25 meningiomas (60%), 12 epidermoid cysts / cholesteatomata (28%), and five other tumours. In patients with meningiom as, symptoms differed considerably from patients presenting with vestibular schwannomas. Cerebellar signs were present in 52% and hearing loss in only 68%. Twenty per cent of patients had hydrocephalus at the time of diagnosi s. After surgical resection, normal facial nerve function was preserved in 75% of cases. In the epidermoid group, fifth, seventh, and eighth nerve def icits were present in 42%, 33%, and 66% respectively. There were no new pos toperative facial palsies. There were two recurrences (17%) requiring reope ration. Overall, there were two perioperative deaths from pneumonia and men ingitis. Conclusions-Patients with non-acoustic lesions of the cerebellopontine angl e often present with different symptoms and signs from those found in patie nts with schwannomas. Hearing loss is less prevalent and cerebellar signs a nd facial paresis are more common as presenting features. Hydrocephalus is often present in patients presenting with cerebellopontine angle meningioma s. Non-acoustic tumours can usually be resected with facial nerve preservat ion.