Combination Of Neuroendoscope And Microscope In Microsurgical Treatment Of Cerebellopontine Angle Meningiomas

ObjectiveTo explore the clinical application value and advantages of microsurgical neurosurgery in the treatment of cerebellopontine meningiomas under the "microscopic-endoscopic combination".MethodsRetrospective analysis of 39 cases of cerebellopontine meningiomas treated by suboccipital retrosigmoid approach microsurgery from January2016 to January 2020 in the Department of Neurosurgery,The First Affiliated Hospital of Chongqing Medical University,of which 11 cases were cerebellopontine meningiomas treated under the "microscopic-endoscopic combination"(microscopic-endoscopic combined group),the other 28 cases were cerebellopontine meningiomas treated under the microscope(microscope group).ResultsIn the microscopic-endoscopic combined group,there were 9 cases of simpson grade I and II resection,and 2 cases of near total resection.The total tumor removal(simpson grade I and II)was achieved in 81.8%.In the microscope group,there were 19 cases of simpson grade I and II resection,5 cases of near total resection,and 4 cases of partial resection.The total tumor removal(simpson grade I and II)was achieved in 67.9%.The anatomical preservation of the facial nerve was achieved in both groups of cases.For the meningiomas showed involvement of the internal auditory canal(IAC),and were located anterior or posterior to the IAC,the facial nerve function preservation rate in the microscopic-endoscopic combined group was 71.4%,and the facial nerve function preservation rate in the microscope group was 66.7%.Conclusion"microscopic-endoscopic combined" operation mode is an effective treatment method for cerebellopontine meningiomas,especially for the treatment of cerebellopontine meningiomas that grow into the IAC or extend into the tentorium.The combination of neuroendoscopy and microscopy can complement each other,improve the rate of total tumor removal,and reduce nerve function damage.