Abstract
Objective: This study aimed to highlight the clinical and radiological profile of cerebellopontine angle (CPA) tumours and assess surgical outcomes, particularly in relation to tumour size.
Materials and Methods: Thirty patients with CPA tumours were prospectively studied in the Department of Neurosurgery, UPUMS Saifai, India, from June 2022 to May 2025. Preoperative assessment included CT and/or MRI. All patients underwent tumour excision through a suboccipital retrosigmoid approach.
Results: A female predominance was noted. Sensorineural hearing loss (92%) was the most common presenting symptom, followed by headache (66%). Most vestibular schwannomas showed heterogeneous enhancement with cystic changes. Large tumors (26–40 mm) were observed in 68% of patients. Facial nerve preservation was achieved in 82% of medium-sized tumours (10–30 mm), whereas postoperative facial palsy was more frequent in giant tumours (>40 mm), suggesting a direct association between tumour size and facial nerve dysfunction. Postoperative complications included CSF leak in 8 patients, hydrocephalus in 3, and mortality in 4 (overall 8%).
Conclusion: CPA tumours were more common in middle-aged patients, with a slightly higher incidence in females. The majority were large at the time of diagnosis, and most patients presented with non-serviceable hearing. Vestibular schwannoma was the most common histopathological diagnosis, often showing heterogeneous and cystic features. Gross total excision was feasible in most cases. Facial nerve palsy was the leading postoperative complication, with larger tumours carrying greater risk. The overall mortality was 8%.
