This document provides information on the diagnosis and management of cerebellopontine angle tumors, specifically vestibular schwannomas. It discusses the history, clinical presentation, imaging findings, classification systems, differential diagnosis, and treatment options including observation, surgery, and radiotherapy. Treatment is typically individualized based on factors like tumor size, hearing status, and patient preferences. A multidisciplinary approach is emphasized.

2. • Less common differentials -
Lak AM, Khan YS. Cerebellopontine Angle Cancer. [Updated 2021 Nov 16]. In: StatPearls [Internet].
Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK559116/

3. 1894
1917
Sir Charles Alfred Ballance

4. • 1949
• 1950
• 1961
• 1973

5. • Vestibular schwannoma
• Antoni A
• Antoni B
S-
100 positivity

8. • Lateral
• Medial
• Anterior
• Posteriorly
• Contents
Cerebellopontine Angle
Vinicio M.F.Valente

10. Koos Classification of Vestibular Schwannomas: A Reliability Study - Neurosurgery Blog

13. • Audio-vestibular
• Cerebellar
• Cranial nerve function-

14. • Asymmetric
sensorineural hearing
loss
poor
speech discrimination

15. Shambaugh Surgery o the Ear

16. • CT scanning For patients intolerant of MRI, or
when it is contraindicated, air-
contrast CT is capable
of showing intra-canalicular
tumour.
For this, air is inserted into the
subdural space byway of a lumbar
puncture. Following
removal of cerebrospinal fluid.

20. Observation
Surgery
Radiotherapy

22. • Indications
• Contraindications
• Disadvantage

24. Advantage Complication/ disadvantage
Nerve preservation
decreased hospitalization time
Post surgery recurrence – salvage therapy
Cranial neuropathies – facial neuropathy , trigeminal
neuropathy
Radiation induced hydrocephalus
Radiation induced sudden sensorineural hearing loss
Childhood irradiation – radiation induced malignancy

25. • Multidiciplinary approach
• Principle

27. Image source – you tube
,UT southwestern medical
centre .
Cameron c wick, md

28. Image source – you
tube ,UT
southwestern
medical centre .
Cameron c wick, md

29. Image source
– you tube
,UT
southwestern
medical
centre .
Cameron c
wick, md

30. • Indications
• Contraindication

31. Source – AANS video journal

32. Source – AANS video journal

33. Source – AANS video journal

34. Source – AANS video journal

35. Source – AANS video journal

36. Advantages Disadvantages
No tumor size limitation;
Wide exposure of the cerebellopontine angle
Possibility of hearing preservation
Favorable position of the facial nerve, which is most
often deep to the tumor from the surgeon’s
viewpoint.
Inability to expose most lateral EAC

41. • Minimally invasive retrosigmoid
approach
A minimally invasive endoscope assisted retrosigmoid approach for removal of arachnoid cysts
in the internal auditory canal: a step by step description
Arianna Di Stadioa,
, Antonio della Volpeb, Massimo Rallic, Valeria Gambacortaa, Franco Trabalzinid, Laura
Dipietroe, Giampietro Riccia

42. A minimally invasive endoscope assisted retrosigmoid approach for removal of arachnoid cysts in the
internal auditory canal: a step by step description
Arianna Di Stadioa,
, Antonio della Volpeb, Massimo Rallic, Valeria Gambacortaa, Franco Trabalzinid, Laura Dipietroe,
Giampietro Riccia

45. Kondziolka, D., Mousavi, S. H., Kano, H., Flickinger, J. C., & Lunsford, L. D. (2012).The newly
diagnosed vestibular schwannoma: radiosurgery, resection, or observation?, Neurosurgical
Focus FOC, 33(3), E8. Retrieved Feb 17, 2022, from
https://thejns.org/focus/view/journals/neurosurg-focus/33/3/2012.6.focus12192.xml

51. Thank you