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Audio-vestibular findings in meningioma of the cerebello-pontine angle: a retrospective review

  • David M. Baguley (a1), Graham J. Beynon (a1), Philip L. Greyf (a2) (a3), David G. Hardya (a4) and David A. Moffat (a2)...


The aim of this study was the determination of the incidence of symptoms of audio-vestibular dysfunction and of abnormalities on audio-vestibular testing in patients found to have a unilateral meningioma of the cerebello-pontine angle (CPA). The case notes of 25 patients diagnosed with unilateral, sporadic and histologically proven CPA meningioma were retrospectively reviewed. The age range of this series was 31–71 years, with a mean age of 50 years. Two patients were male (eight per cent) and 23 were female (92 per cent). The mean length of history was 44.7 months. The distribution of tumour size was skewed toward larger tumours, with 15 cases (60 per cent) having tumours with a maximum diameter greater than 3.5 cm on imaging. Pure tone audiometry was normal in five cases (20 per cent), and no patients exhibited the high frequency sensorineural hearing loss that is characteristic of vestibular schwannoma. Speech audiometry was normal in 50 per cent of cases. Caloric testing was abnormal in 77 per cent of the 18 cases tested, whilst auditory brainstem responses (ABR) were abnormal in 100 per cent of the 18 cases who had sufficient hearing for this test to be possible. The presence of normal audiometry in patients with a proven CPA lesion indicates that, if in a protocol for investigation, asymmetry of hearing is mandatory then some pathology will be missed. Any suspicion of a CPA lesion warrants investigation even in the absence of hearing loss.

The investigation of choice for the identification of CPA lesions has become magnetic resonance imaging (MRI). If this technique is not available then this study indicates that ABR is a suitable and sensitive investigation. It should be borne in mind however that the data in this study has been derived from a series of predominantly large tumours, and the sensitivity of ABR to smaller CPA meningiomata may fall, as is the case for vestibular schwannoma.


Corresponding author

Address for correspondence: David M. Baguley, M.Sc., M.B.A., Department of Audiology (94), Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ. Fax: 01223 217559 e-mail:


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Aiba, T., Yamada, T., Umezu, H., Takemori, S. (1992) Clinical Characteristics of Rare Cerebello-pontine Angle Tumours: Comparison with Acoustic Tumors. Proceedings of the First International Conference on Acoustic NeuromaKugler PublicationsNew York, pp 933938.
Baguley, D. M. (1995) The changing face of audiological test strategy. In Recent Advances in Otolaryngology. (Moffat, D.A. ed.) Churchill Livingstone, London pp 7585.
Bartels, L. J., Arrington, J. (1994) Rare tumours of the cerebello-pontine angle. In Neurotology. (Jackler, R. K., Brackmann, D. E. eds.) Mosby, St Louis, pp. 835862.
Boothroyd, A. (1968) Developments in speech audiometry. Sound 2: 310.
Fisher, E. W., Parikh, A. A., Harcourt, J. P., Wright, A. (1994) The burden of screening for acoustic neuroma: asymmetric symptoms in the ENT clinic. Clinical Otolaryngology 19: 1921.
Fitzgerald, G., Hallpike, C. S. (1942) Studies in human vestibular function. I. Observations on the directional preponderance (nystagmusbereitschaft) of caloric nystagmus resulting from cerebral lesions. Brain 65: 117137.
Glasscock, M. E. III, Minor, L. B., McMenomey, S. O. (1994) Meningiomas of the cerebello-pontine angle. In Neurotology. (Jackler, R. K., Brackmann, D. E. eds.) Mosby, St Louis, pp 795822.
Granick, M. S., Martuza, R. L., Parker, S. W., Ojemann, R. G., Montgomery, W. W. (1985) Cerebello-pontine angle meningiomas: clinical manifestations and diagnosis. Annals of Otology, Rhinology and Laryngology 94: 3438.
Hart, M. J., Lillehei, K. O. (1995) Management of posterior cranial fossa meningiomas. Annals of Otology, Rhinology and Laryngology 104: 105116.
Jackler, R. K., Lalwani, A. K. (1992) Preoperative Differentiation between Acoustic Neuroma and Meningioma of the Cerebello-pontine Angle. Proceedings of the First International Conference on Acoustic NeuromaKugler PublicationsNew York, pp 939944.
Laird, F. J., Harner, S. G., Laws, E. R., Reese, D. F. (1985) Meningiomas of the cerebello-pontine angle. Otolaryngology – Head and Neck Surgery 93: 163169.
Luxon, L. (1995) Comparison of caloric nystagmus by observation of duration and by electronystagmographic measurement of slow phase velocity. British Journal of Audiology 29:107116.
Moffat, D. A., Hardy, D. G., Irving, R. M., Viani, L., Beynon, G. J., Baguley, D. M. (1995) Referral patterns in vestibular schwannomas. Clinical Otolaryngology 20: 8083.
Prasher, D., Coelho, A., Nadkarni, N., Luxon, L. (1992) Differentiating an acoustic neuroma from other cerebellopontine angle lesions. Proceedings of the First International Conference on Acoustic NeuromaKugler PublicationsNew York, pp 953956.
Sekhar, L. N., Janetta, P. J. (1984) Cerebellopontine angle meningiomas. Journal of Neurosurgery 60: 500505.
Selesnick, S. H., Jackler, R. K., Pitts, L. W. (1993) The changing presentation of acoustic tumours in the MRI era. Laryngoscope 103: 431436.



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