Xie Zhengxing ^* Yan Zhuang Jieping Liu

• Department of Neurosurgery,The Affiliated Hospital of Jiangsu University, Zhengjiang, China

Background Surgery for tumors in cerebellopontine angle is always a great challenge, because of densely packed neurovascular structures, narrow deep location as well as complicated relation between lesions and surrounding neurovascular structures. Recently a great attention has been paid to neuroendoscope for its exclusive advantage, which has added a new dimension to many classical microscopic surgeries. However, the feasibility and advisability of fully endoscopic neurosurgery for cerebellopontine angle tumor remains to be further evaluated. Methods We retrospectively collected the clinical outcomes and endoscopic surgical experience of 12 patients with tumors in CPA from Jan 2022 to Apr 2024 in our department. We analyzed patients’ records, radiological neuroimaging, tumor-related variables and surgical procedures in detail, as well as postoperative outcomes. All patients were followed up for neurological examinations and Magnetic resonance Imaging (MRI)/computed tomography (CT) regularly after surgery. Results The pathology of the series included five cases of acoustic neuroma, six cases of meningioma, one case of teratoma. The mean largest diameter of the lesion was 29.5±8.5mm.Headache, hearing lose, and dizzy were top three symptoms. All tumors were resected via two- hand technique. None hemorrhage, cerebrospinal fluid leak or intracranial infection occurred. All patients with meningioma achieved Simpson grade Ⅱ resection, and the remain tumors achieved gross total resection confirmed by both intraoperative and postoperative imaging. Overall, 91.7% of patients maintained normal facial nerve function postoperation (HB1 ). One patient with acoustic neuroma suffered from a transient facial paralysis after surgery (HB2), which recovered during follow-up at 3months postoperation. Clinical symptoms of all the other patients had been resolved or ameliorated after surgery without any new neurologic deficits. The Karnofsky Performance Scale (KPS) scores remained unchanged or improved for all patients postoperatively. Conclusions With the accumulation of experience and technological progress, the fully endoscopic retrosigmoid approach could enable safe and effective resection of cerebellopontine angle tumor which can provide a panoramic view and illumination of the deep-seated structures.