Hostname: page-component-7479d7b7d-wxhwt Total loading time: 0 Render date: 2024-07-12T19:18:55.374Z Has data issue: false hasContentIssue false
  • English
  • Français

Audio-vestibular findings in meningioma of the cerebello-pontine angle: a retrospective review

Published online by Cambridge University Press:  29 June 2007

David M. Baguley ,
Graham J. Beynon ,
Philip L. Greyf ,
David G. Hardya  and
David A. Moffat
David M. Baguley*
Affiliation:
Department of Audiology, Addenbrooke's Hospital, Cambridge, UK
Graham J. Beynon
Affiliation:
Department of Audiology, Addenbrooke's Hospital, Cambridge, UK
Philip L. Greyf
Affiliation:
Departments of Otolaryngology, Addenbrooke's Hospital, Cambridge, UK ENT Department, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
David G. Hardya
Affiliation:
Departments of Neurosurgeryt, Addenbrooke's Hospital, Cambridge, UK
David A. Moffat
Affiliation:
Departments of Otolaryngology, Addenbrooke's Hospital, Cambridge, UK
*
Address for correspondence: David M. Baguley, M.Sc., M.B.A., Department of Audiology (94), Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ. Fax: 01223 217559 e-mail: dmb29@cam.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

The aim of this study was the determination of the incidence of symptoms of audio-vestibular dysfunction and of abnormalities on audio-vestibular testing in patients found to have a unilateral meningioma of the cerebello-pontine angle (CPA). The case notes of 25 patients diagnosed with unilateral, sporadic and histologically proven CPA meningioma were retrospectively reviewed. The age range of this series was 31–71 years, with a mean age of 50 years. Two patients were male (eight per cent) and 23 were female (92 per cent). The mean length of history was 44.7 months. The distribution of tumour size was skewed toward larger tumours, with 15 cases (60 per cent) having tumours with a maximum diameter greater than 3.5 cm on imaging. Pure tone audiometry was normal in five cases (20 per cent), and no patients exhibited the high frequency sensorineural hearing loss that is characteristic of vestibular schwannoma. Speech audiometry was normal in 50 per cent of cases. Caloric testing was abnormal in 77 per cent of the 18 cases tested, whilst auditory brainstem responses (ABR) were abnormal in 100 per cent of the 18 cases who had sufficient hearing for this test to be possible. The presence of normal audiometry in patients with a proven CPA lesion indicates that, if in a protocol for investigation, asymmetry of hearing is mandatory then some pathology will be missed. Any suspicion of a CPA lesion warrants investigation even in the absence of hearing loss.

The investigation of choice for the identification of CPA lesions has become magnetic resonance imaging (MRI). If this technique is not available then this study indicates that ABR is a suitable and sensitive investigation. It should be borne in mind however that the data in this study has been derived from a series of predominantly large tumours, and the sensitivity of ABR to smaller CPA meningiomata may fall, as is the case for vestibular schwannoma.

Keywords

MeningiomaCerebellopontine angleAudiologyDiagnosis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 11 , November 1997 , pp. 1022 - 1026
Copyright
Copyright © JLO (1984) Limited 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aiba, T., Yamada, T., Umezu, H., Takemori, S. (1992) Clinical Characteristics of Rare Cerebello-pontine Angle Tumours: Comparison with Acoustic Tumors. Proceedings of the First International Conference on Acoustic NeuromaKugler PublicationsNew York, pp 933–938.Google Scholar
Baguley, D. M. (1995) The changing face of audiological test strategy. In Recent Advances in Otolaryngology. (Moffat, D.A. ed.) Churchill Livingstone, London pp 75–85.Google Scholar
Bartels, L. J., Arrington, J. (1994) Rare tumours of the cerebello-pontine angle. In Neurotology. (Jackler, R. K., Brackmann, D. E. eds.) Mosby, St Louis, pp. 835–862.Google Scholar
Boothroyd, A. (1968) Developments in speech audiometry. Sound 2: 3–10.Google Scholar
Fisher, E. W., Parikh, A. A., Harcourt, J. P., Wright, A. (1994) The burden of screening for acoustic neuroma: asymmetric symptoms in the ENT clinic. Clinical Otolaryngology 19: 19–21.CrossRefGoogle ScholarPubMed
Fitzgerald, G., Hallpike, C. S. (1942) Studies in human vestibular function. I. Observations on the directional preponderance (nystagmusbereitschaft) of caloric nystagmus resulting from cerebral lesions. Brain 65: 117–137.Google Scholar
Glasscock, M. E. III, Minor, L. B., McMenomey, S. O. (1994) Meningiomas of the cerebello-pontine angle. In Neurotology. (Jackler, R. K., Brackmann, D. E. eds.) Mosby, St Louis, pp 795–822.Google Scholar
Granick, M. S., Martuza, R. L., Parker, S. W., Ojemann, R. G., Montgomery, W. W. (1985) Cerebello-pontine angle meningiomas: clinical manifestations and diagnosis. Annals of Otology, Rhinology and Laryngology 94: 34–38.CrossRefGoogle Scholar
Hart, M. J., Lillehei, K. O. (1995) Management of posterior cranial fossa meningiomas. Annals of Otology, Rhinology and Laryngology 104: 105–116.CrossRefGoogle ScholarPubMed
Jackler, R. K., Lalwani, A. K. (1992) Preoperative Differentiation between Acoustic Neuroma and Meningioma of the Cerebello-pontine Angle. Proceedings of the First International Conference on Acoustic NeuromaKugler PublicationsNew York, pp 939–944.Google Scholar
Laird, F. J., Harner, S. G., Laws, E. R., Reese, D. F. (1985) Meningiomas of the cerebello-pontine angle. Otolaryngology – Head and Neck Surgery 93: 163–169.CrossRefGoogle Scholar
Luxon, L. (1995) Comparison of caloric nystagmus by observation of duration and by electronystagmographic measurement of slow phase velocity. British Journal of Audiology 29:107–116.CrossRefGoogle ScholarPubMed
Moffat, D. A., Hardy, D. G., Irving, R. M., Viani, L., Beynon, G. J., Baguley, D. M. (1995) Referral patterns in vestibular schwannomas. Clinical Otolaryngology 20: 80–83.CrossRefGoogle ScholarPubMed
Prasher, D., Coelho, A., Nadkarni, N., Luxon, L. (1992) Differentiating an acoustic neuroma from other cerebellopontine angle lesions. Proceedings of the First International Conference on Acoustic NeuromaKugler PublicationsNew York, pp 953–956.Google Scholar
Sekhar, L. N., Janetta, P. J. (1984) Cerebellopontine angle meningiomas. Journal of Neurosurgery 60: 500–505.CrossRefGoogle ScholarPubMed
Selesnick, S. H., Jackler, R. K., Pitts, L. W. (1993) The changing presentation of acoustic tumours in the MRI era. Laryngoscope 103: 431–436.CrossRefGoogle ScholarPubMed