AB087. Rectosigmoid approach for cerebellopontine angle tumors: what have we learned so far?

Background: The cerebellopontine angle (CPA) is a multifaceted triangular region bordered by the brainstem medially, the cerebellum superiorly and posteriorly, and the temporal bone laterally. Tumors located in the CPA comprise 5% to 10% of all intracranial neoplasms, with vestibular schwannomas being the most prevalent, followed by meningiomas and epidermoid tumors. Various surgical approaches exist for removing these lesions, which consistently present challenges for neurosurgeons in effectively managing them. This study presents a case of a CPA tumor successfully treated via the retrosigmoid approach, followed by an assessment of the approach's efficacy and surgical outcomes.

Methods: A comprehensive literature search was conducted using electronic databases, including PubMed, ScienceDirect, and Google Scholar, to gather studies on surgically managed CPA tumors. In addition to reviewing the literature, we present a case study of a patient with CPA tumor who underwent surgery using the retrosigmoid approach.

Results: The literature review revealed that the retrosigmoid approach emerged as a commonly utilized technique, particularly for tumors in the CPA region. Analysis of the collected data indicated that the retrosigmoid approach offers several advantages, including excellent exposure of the CPA, minimal brain retraction, and reduced risk of injury to critical neurovascular structures. Moreover, studies consistently reported favorable surgical outcomes, with low rates of morbidity and mortality associated with this approach. In our case study, we successfully employed the retrosigmoid approach to resect a CPA tumor in a patient presenting with typical symptoms of spasticity in all four extremities and progressive hearing loss.

Conclusions: In conclusion, the retrosigmoid approach remains a valuable surgical technique for the management of CPA tumors. This approach enhances the exposure of the CPA and increases the surgical angle of maneuverability. In most literature, the retrosigmoid approach provides adequate access that is safe and effective, with a low rate of postoperative complications. However, further prospective studies and comparative analyses are warranted to validate these findings and refine surgical techniques for optimizing patient outcomes.