Posterior Petrous Meningiomas: Auditory and Facial Nerve Function after Surgery

Objective: The aim of the study is to present our experience in the surgical treatment of posterior petrous meningiomas in regard to long-term auditory and facial nerve postoperative function.

Methods: A series of 56 consecutive patients operated on for posterior petrous meningiomas between 2002 and 2014 is reported. There were 51 women and 5 men in the study group. The main symptom on first admission was hypoacusis (29 patients). 17 patients with hypoacusis had still functional hearing. In four patients seventh nerve deficit was found on admission. The tumor was found to be attached to the premeatal, inframeatal, and retromeatal dura in 48, 27, and 25% of patients, respectively. Tumor resection was complete (Simpson Grade I and II) in 53 cases (95%). The petrosal approach and retrosigmoid approach were suitable for posteriori petrous meningiomas.

Results: Postoperative facial nerve dysfunction appeared in 14 patients (including transient facial nerve deficit in 4) and further deteriorated in 2 patients. Hearing function deteriorated after surgery in 14 (including new deficit in 4) and improved in 3 patients. Perioperative death occurred in 2 patients.

Conclusion: Surgical treatment of posterior petrous meningiomas has become increasingly safe but these tumors still remain a surgical challenge because of the relatively high incidence of permanent facial and auditory nerve dysfunction. The site of displacement of the cranial nerves depending on the dural origin of the tumor has the most influence on the related difficulties in its removal.