![]() Many other masses can present at or around the cerebellopontine angle. epidermoid cyst: third most common (~5%).ruptured intracranial dermoid cyst: often multiple droplets with original midline lesion still often seen.cerebellopontine angle lipoma: usually has the facial nerve and vestibulocochlear nerve coursing through it saturates on fat suppressed sequences.1 VSs may remain within the internal auditory canal (IAC) or extend into the CPA. white epidermoid: rare restricts on DWI Vestibular schwannomas (VSs) are benign neoplasms of the nerve sheath and account for 68 of all intracranial tumors and 80 of cerebellopontine angle (CPA) tumors. ![]() thrombosed berry aneurysm: often will have a calcified rim and hemosiderin staining.neurenteric cyst: usually prepontine, but fluid may be proteinaceous and high on T1.vestibular schwannoma: most common by far (~80%).PathologyĬerebellopontine angle masses can be divided into four groups, based on imaging characteristics:Īlternatively, a quick mnemonic to remember the common entities affecting the cerebellopontine angle is AMEN or SAME. Although a diverse range of pathologies may be seen in this region, the most common by far is vestibular schwannoma. Conclusion: Arachnoid cysts can develop within the internal auditory canal or facial nerve canal. All rights reserved.C erebellopontine angle (CPA) masses are relatively common. Definitive pathologicdiagnosis should be strongly considered to help tailor treatment.Īcoustic neuroma Arachnoid cyst Cavernous hemangioma Cochlear schwannoma Facial schwannoma Intermedius schwannoma Internal auditory canal Lipochoristoma Meningioma Mucosa-associated lymphoid tissue (MALT) lymphoma.Ĭopyright © 2016 Elsevier Inc. Five-year average follow-up revealed one patient with recurrence.Ĭlinical examination and imaging alone were insufficient to correctly identify these tumors. The petrous apex is a complex region of the central skull base that is surrounded by a number of important vascular and neural structures and can be home to a wide range of disease processes. Few complications occurred, including facial nerve palsy, loss of hearing, and vestibular function. Objective: To investigate prevalence, radiological characteristics, and functional correlates of arachnoid cysts (AC) of the internal auditory canal (IAC) region, including associations of nerve. Three operative approaches were used: the retrosigmoid approach, middle fossa subtemporal approach, or translabyrinthine approach. None of these rare tumors could be identified before surgery. Rare IAC tumors are not all radiosensitive and are poorly described.īetween 19, 289 consecutive patients with IAC lesions operated on were reviewed retrospectively.įifteen patients (5.2%) (16 operations) had unusual histologic findings, including nonvestibular schwannomas (2 facial schwannomas, 2 cochlear schwannomas, 2 intermedius schwannomas), 3 meningiomas, 3 cavernous hemangiomas, a mucosa-associated lymphoid tissue lymphoma, an arachnoid cyst, and a lipochoristoma. Many undergo stereotactic radiation without definitive tissue diagnosis. Electronic address: 95% of tumors occurring within the internal auditory canal (IAC) are vestibular schwannomas. 6 Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA. As the tumor becomes larger, degenerative changes may occur in its center with formation of cysts.Electronic address: 1 Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA Department of Neurosurgery, Hôpital Lariboisirère, Paris VII-Diderot University, Paris, France. 6 Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.5 Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA Department of Neurosurgery, Southern TOHOKU General Hospital, Koriyama, Fukushima, Japan.4 Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA Department of Neurosurgery, Fukushima Takanori Skull Base Center, Shinyurigaoka General Hospital, Kanagawa, Japan.This disease may also affect the results. When looking into the ear, the health care provider may see cysts or benign tumors in the ear canal. This type of exam may include hearing tests ( audiometry) and middle ear testing ( tympanometry ). 3 Department of Surgery, Division of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Duke Otolaryngology of Raleigh, Raleigh, North Carolina, USA. Benign cysts and tumors are most often found during a routine ear exam.2 Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.1 Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA Department of Neurosurgery, Hôpital Lariboisirère, Paris VII-Diderot University, Paris, France.
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