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

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

Husni Harmansyah1, Djoko Widodo1,2

1Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia; 2Department of Surgery, Wahidin Sudirohusodo Central Hospital, Makassar, Indonesia

Correspondence to: Husni Harmansyah, MD. Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Hasanuddin University, Perintis Kemerdekaan KM 10, Makassar, South Sulawesi 90245, Indonesia. Email: husniharmansyah@gmail.com; Djoko Widodo, MD. Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Hasanuddin University, Perintis Kemerdekaan KM 10, Makassar, South Sulawesi 90245, Indonesia; Department of Surgery, Wahidin Sudirohusodo Central Hospital, Makassar, Indonesia. Email: djokwid@yahoo.com.

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.

Keywords: Cerebellopontine angle (CPA); retrosigmoid approach; tumors

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://cco.amegroups.com/article/view/10.21037/cco-24-ab087/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the editorial office of this journal.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

Cite this abstract as: Harmansyah H, Widodo D. AB087. Rectosigmoid approach for cerebellopontine angle tumors: what have we learned so far? Chin Clin Oncol 2024;13(Suppl 1):AB087. doi: 10.21037/cco-24-ab087

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