Clinical, surgical and postoperative outcome analysis of tumors occupying both posterior and middle cranial fossa

Authors

  • Rahul Singh Senior Resident, Department of Neurosurgery, Institute of Medical Sciences – Banaras Hindu University, Varanasi, Uttar Pradesh, India https://orcid.org/0000-0001-5626-445X
  • Ravi Shankar Prasad Associate Professor and Head, Department of Neurosurgery, Institute of Medical Sciences – Banaras Hindu University, Varanasi, Uttar Pradesh, India https://orcid.org/0000-0002-4854-9030
  • Ramit Chandra Singh Senior Resident, Department of Neurosurgery, Institute of Medical Sciences – Banaras Hindu University, Varanasi, Uttar Pradesh, India
  • Kulwant Singh Professor, Department of Neurosurgery, Institute of Medical Sciences – Banaras Hindu University, Varanasi, Uttar Pradesh, India https://orcid.org/0000-0001-7957-5760
  • Anurag Sahu Associate professor, Department of Neurosurgery, Institute of Medical Sciences – Banaras Hindu University, Varanasi, Uttar Pradesh, India https://orcid.org/0000-0002-7857-4886

DOI:

https://doi.org/10.3126/njn.v18i2.33783

Keywords:

Trigeminal Schwannoma, Vestibular Schwannoma, middle cranial fossa, posterior cranial fossa, epidermoid

Abstract

Objectives: To analyse clinical, surgical and postoperative outcome perspectives of tumors occupying both middle and posterior cranial fossa.

Materials and Methods: This retrospective cohort study includes 23 patients operated for tumors involving both middle and posterior cranial fossa in our department between August 2016 and August 2020. Each patient was evaluated for age, sex, co morbidities, tumour histopathology, clinical presentation, radiological characteristics, surgical and outcome characteristics. Unpaired t- test and chi-square test was used for statistical analysis. P < 0.05 was considered statistically significant.

Results: The mean age was 46 years (range 40–57 years), with the majority of patients being female (56.5%). Most tumors (65.3%) were trigeminal schwannoma, with the remaining being vestibular schwannoma (21.7%), facial schwannoma (8.7%) and epidermoid (4.3%). The most commonly used surgical approach was the retrosigmoid approach (30.4%) and combined approach (30.4%).  Gross total resection (GTR) was done in 14 patients while subtotal resection (STR) was done in 9 patients. STR was significantly associated (p<0.05) with persisting cranial nerve deficit and tumour progression.  Midbrain compression, internal carotid artery and cavernous sinus involvement were significantly (p<0.05) associated with STR.

Conclusions: Trigeminal schwannoma is the most common tumour involving both middle and posterior cranial fossa. Combined approach for such tumours is required in tumours having significant size in both middle cranial fossa and posterior cranial fossa. The intent of surgery is to achieve a gross total resection (GTR) but adhesions and involvement of critical brain structures results in STR.

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Author Biographies

Rahul Singh, Senior Resident, Department of Neurosurgery, Institute of Medical Sciences – Banaras Hindu University, Varanasi, Uttar Pradesh, India

Senior Resident, Department of Neurosurgery, Institute of Medical Sciences – Banaras Hindu University, Varanasi, Uttar Pradesh, India

Ravi Shankar Prasad, Associate Professor and Head, Department of Neurosurgery, Institute of Medical Sciences – Banaras Hindu University, Varanasi, Uttar Pradesh, India

Associate Professor and Head, Department of Neurosurgery, Institute of Medical Sciences – Banaras Hindu University, Varanasi, Uttar Pradesh, India

Ramit Chandra Singh, Senior Resident, Department of Neurosurgery, Institute of Medical Sciences – Banaras Hindu University, Varanasi, Uttar Pradesh, India

Senior Resident, Department of Neurosurgery, Institute of Medical Sciences – Banaras Hindu University, Varanasi, Uttar Pradesh, India

Kulwant Singh, Professor, Department of Neurosurgery, Institute of Medical Sciences – Banaras Hindu University, Varanasi, Uttar Pradesh, India

Professor, Department of Neurosurgery, Institute of Medical Sciences – Banaras Hindu University, Varanasi, Uttar Pradesh, India

Anurag Sahu, Associate professor, Department of Neurosurgery, Institute of Medical Sciences – Banaras Hindu University, Varanasi, Uttar Pradesh, India

Associate professor, Department of Neurosurgery, Institute of Medical Sciences – Banaras Hindu University, Varanasi, Uttar Pradesh, India

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Published

2021-05-07

How to Cite

1.
Singh R, Prasad RS, Singh RC, Singh K, Sahu A. Clinical, surgical and postoperative outcome analysis of tumors occupying both posterior and middle cranial fossa. Nep J Neurosci [Internet]. 2021 May 7 [cited 2024 Mar. 28];18(2):36-44. Available from: https://www.nepjol.info/index.php/NJN/article/view/33783

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Section

Original Articles