Comparative analysis of clinical outcomes cerebellopontine angle meningioma versus cerebellopontine angle schwannoma: A retrospective insight from Pakistan

Abstract

Background and Objective: Meningiomas follow schwannoma as the second common space occupying lesions (SOL) in the cerebellopontine angle (CPA). Tissue-based differences in outcomes for these neoplasms using retrosigmoid approach have not been studied previously. We aimed to evaluate tumor characteristics and surgical outcomes based on tumor histopathology

Methodology: This retrospective observational study was conducted at the Department of neurosurgery in Punjab Institute of Neurosciences, involving consecutive, single-surgical team led cases of CPA space occupying lesions (SOL) between 2021 and 2024. Chi-square test was used to determine any significant differences between Schwannomas and meningiomas in terms of tumor consistency, vascularity, extent of resection and postoperative complications. Fischer’s exact test was applied when expected cell counts were low.

Results: Of the hundred patients included, 63 were the cases of Schwannoma and 37 were meningioma of CPA. A male preponderance of 57.1% (36) with an overall mean age of 37.7±13.4 years was noted in the Schwannoma group. Contrastingly, 56.8% patients were females with an overall mean age 39.3±13.1 years in the meningioma group. A significant association in occurrence of postoperative facial nerve weakness and loss of gag reflex between Schwannomas and meningiomas was seen i.e., χ²(1)= 6.52 p = 0.007 and χ²(1) = 12.94, p = 0.000, respectively (with significant results for Fischer exact test as well i.e., p<0.05). Gross total resection was achievable in 88.9% (56) cases of Schwannoma and 100% (37) of meningioma, but no significant differences in tumor consistency, vascularity and extent of resection were observed between Schwannomas and meningiomas i.e., χ²(2)= 5.40 p= .067, χ²(3)= 5.89 p= .117 and χ²(2)= 4.42 p= 0.11, respectively.

Conclusion: Schwannomas were more likely to have postoperative facial nerve weakness and loss of gag reflex in comparison to meningiomas. However, there are no significant differences between Schwannomas and meningiomas in terms of tumor consistency, vascularity and extent of resection.