Ali Muhammad Salman, Magill Stephen T, McDermott Michael W
Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, United States.
Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, United States.
Handb Clin Neurol. 2020;170:157-165. doi: 10.1016/B978-0-12-822198-3.00037-9.
Cerebellopontine angle (CPA) meningiomas arise from the petrous face of the temporal bone, which forms the lateral boundary of the CPA. They can be categorized into anterior, middle, and posterior, based on their attachment in relation to the internal acoustic meatus. Each of them presents with their own characteristic clinical syndromes. Because of their close proximity to neurovascular structures, they pose a challenge during surgery. Microsurgery remains the primary treatment modality for large and symptomatic meningiomas. The retrosigmoid approach provides an ideal access for most of the tumors in this location. Radiosurgery is the primary modality of adjuvant therapy for residual, recurrent, and small lesions. Fully fractionated external beam radiotherapy can be used for larger, broader-based residual/recurrent tumors. Management of these complex lesions should include patient preferences and a team approach, including a skull base neurosurgeon, neurotologist, and radiation oncologist.
桥小脑角（CPA）脑膜瘤起源于颞骨岩面，该岩面构成桥小脑角的外侧边界。根据其与内耳道的附着关系，可分为前部、中部和后部。它们各自呈现出独特的临床综合征。由于它们与神经血管结构关系密切，手术时具有挑战性。显微手术仍然是大型有症状脑膜瘤的主要治疗方式。乙状窦后入路为该部位的大多数肿瘤提供了理想的入路。放射外科是残留、复发和小病灶辅助治疗的主要方式。全分割外照射放疗可用于较大、基底较宽的残留/复发肿瘤。这些复杂病变的管理应考虑患者偏好并采用团队方法，包括颅底神经外科医生、耳神经科医生和放射肿瘤学家。
