[Cerebellopontine angle surgery. Part 1: General remarks]

Abstract

Objectives: Cerebellopontine angle tumors, although uniform in location, are diverse with regard to the site of tumor origin and displacement of the neurovascular structures. With the increasing use of magnetic resonance imaging in the diagnosis of brain lesions, the treatment of tumors of the cerebellopontine angle has changed extraordinarily. An appreciation of the vascular and cranial nerve microanatomy and the intimate relationship between neurovascular structures and the tumor is essential for achieving optimal surgical results

Methods: A review was made of the current literature.

Results and conclusions: The different treatment options are compared with microsurgical tumor resection with respect to neurological outcome and long-term follow-up. As microsurgical removal is still the treatment of choice for such tumors, the indication for surgical treatment is analyzed and the different surgical approaches to the cerebellopontine angle are described in terms of their frequency of involvement in the surrounding neural and vascular structures with varying tumor size. The etiology of facial and cochlear nerve injury, as well as complications involving other cranial nerves, are discussed with emphasis on pathophysiological and anatomical considerations. In conclusion, the great variation in the anatomical location and the involvement of neurovascular structures in the cerebellopontine angle is demonstrated.