A cerebellopontine angle tumor is a tumor located at the angle between the cerebellum and the nearby pons. The so-called petrous bone is also nearby. An acoustic neuroma is present in the majority of cases, but epidermoids, meningiomas, cholesteatomas, a glomus jugular tumor, and brain metastases are also possible.
What is a cerebellar pontine angle tumor?
After thorough consideration of the individual case, the doctor treating you makes the decision to use the diagnostic means. For example, it is possible to carry out an MRI examination in which the cerebellar pontine angle tumor can be differentiated from the surrounding areas. See AbbreviationFinder for abbreviations related to Cerebellopontine Angle Tumor.
Various tumors, which are usually benign, form in the area between the brainstem and cerebellum. Meningiomas and acoustic neuromas are the most common. Cerebellopontine angle tumors may result in failure of certain cranial nerves.
In the later course of the disease, hydrocephalus and compression of the brainstem sometimes occur. Since magnetic resonance imaging has become available as an examination method, cerebellopontine angle tumors are usually diagnosed earlier than in the past.
As a result, the prospects of healing are also significantly more favorable. Today, the goal of surgical intervention is to preserve the functions of the cranial nerves as much as possible. The cerebellopontine angle tumor is partially or completely removed.
Causes
Hardly any reliable statements can currently be made about the causes of the development of cerebellopontine angle tumors. However, medical research strives to elucidate the reasons for the formation of cerebellopontine angle tumors.
Symptoms, Ailments & Signs
Cerebellopontine angle tumors cause many different symptoms and are associated with typical signs. The symptoms vary according to the severity and location of the cerebellopontine angle tumor. In principle, the type of cerebellopontine angle tumor is decisive.
Acoustic neuromas usually cause functional failures of the so-called vestibulocochlear nerve. This results in hearing impairments, which usually occur on one side and last for several months or even years. In addition, the affected patients often suffer from dizziness and tinnitus.
If the facial nerve is affected, the facial muscles will suffer. In connection with meningiomas, there are sometimes inconstant hearing disorders as well as impairments of the trigeminal and facial nerves.
Complaints in the cerebellum such as muscle hypotonia, adiadochokinesis and a lateral gait deviation are also possible. Today, so-called decompensated cerebellar pontine angle tumors have become rare. If nausea, headaches and disturbances of consciousness appear in the case of such an illness, emergency medical treatment is absolutely necessary.
Diagnosis & course of disease
There are a number of possible examination methods available for diagnosing cerebellopontine angle tumors. After thorough consideration of the individual case, the doctor treating you makes the decision to use the diagnostic means. For example, it is possible to carry out an MRI examination in which the cerebellar pontine angle tumor can be differentiated from the surrounding areas.
The epidermoids, which are sometimes difficult to distinguish from other areas, are problematic. In addition, CT examinations are used, which are routinely carried out before surgical interventions. There is also the possibility of electrophysiology.
Here, for example, audiometry and a check of the vestibular are carried out. These examinations are indicated especially before operations. If glomus tumors or special acoustic neuromas are present, laryngoscopy is sometimes necessary.
The corresponding investigations are carried out on an interdisciplinary basis in cooperation with different departments. Computed tomography examines the bony part of the skull base. If the porus acusticus internus is widened, this gives an indication of the disease. Special contrast media are used in magnetic resonance imaging. With their help, tumors can be visualized.
Complications
As a rule, the cerebellopontine angle tumor has a very negative impact on the patient’s life and can significantly reduce the quality of life. In most cases, severe motor and mental disorders occur in the patient. Those affected often suffer from tinnitus or other hearing problems.
Vision can also be impaired by the cerebellar pontine angle tumor. Furthermore, dizzy spells can also occur, which in the further course can lead to complete unconsciousness. It also causes severe headaches and nausea. Consciousness and concentration are also disturbed by the cerebellar pontine angle tumor and normal thinking and acting is no longer easily possible for those affected in most cases.
It is not uncommon for certain regions of the body to be paralyzed by this tumor. The diagnosis can be made relatively quickly, so that early treatment of the tumor can be initiated. In most cases, treatment does not lead to further complications. The tumor can be removed by surgery or radiation. If treatment is started early, there is no reduction in life expectancy.
When should you go to the doctor?
Neurological deficits and dizzy spells indicate a serious illness that needs to be clarified by a doctor. A cerebellar pontine angle tumor progresses slowly and, as it progresses, can cause various auditory canal and neurological system symptoms. Anyone who notices unusual symptoms that cannot be attributed to a specific cause should consult their family doctor. A tinnitus indicates that the tumor is already well advanced and should therefore be clarified immediately. The same applies to nausea, headaches and blurred vision.
Even non-specific symptoms always require a diagnosis. In the event of circulatory problems or even a loss of consciousness, the emergency services must be alerted. The person concerned must then be examined and treated in the hospital. The right contact person is the general practitioner or a neurologist. Children should first go to the pediatrician. If symptoms arise again during or after the removal of the tumor, the doctor must be informed. A recurrence may have developed and a repeat intervention is necessary.
Treatment & Therapy
Various approaches exist with regard to the treatment of cerebellopontine angle tumors. These are used depending on the type, location and stage of the tumor. In the majority of cases, surgical removal of the cerebellopontine angle tumor is sought. Radiosurgery can also be performed.
However, possible complications, such as liquor fistulas or hydrocephalus, must be taken into account. Radiosurgery is primarily used in older people, especially if the patients have meningioma or acoustic neuroma of a lesser extent. In this way, the majority of tumors smaller than three centimeters in size can be stabilized.
In contrast, radiosurgery is not the first choice for glomus tumors. In addition, radiosurgical methods are also used when the risk of complete removal of the cerebellopontine angle tumor is too high. During the operation, the posterior fossa is opened.
Here, electrophysiology and neuronavigation are used to check and maintain the functions of the cranial nerves. In the case of acoustic neuromas, a so-called translabyrinthine access through the auditory canal is also possible. A baseline MRI is required a few months after surgery.
In general, regular follow-up care is necessary. In the case of tumors that have been completely removed, annual follow-up checks must be carried out up to five years after surgical removal. Later, the dates for aftercare will be set individually. The same applies to patients treated with radiosurgery.
Outlook & Forecast
Even if the cerebellopontine angle tumor is easily treatable and often even runs completely symptom-free for many years, the affected person can take action himself. Adherence to the prescribed medication and a change in diet that may be necessary has top priority. In addition, the person concerned must take it easy and, depending on their professional activity, obtain a sick leave if necessary. Pain that occurs can often be adequately treated with cool compresses or pain-relieving teas.
In order to avoid injuries to yourself or others, you must absolutely refrain from driving a vehicle or operating machines if you experience balance disorders or dizziness. If there is only a hearing impairment, temporary wearing of a hearing aid is helpful. In order to relieve the visual senses and prevent worsening of symptoms in poor lighting, it is important to ensure that the lamps are sufficiently bright.
If the tumor is already far advanced when the diagnosis is made, this may lead to impairment of the facial muscles in the form of partial facial paralysis or individual parts slipping into a grimace. The mental suffering in this phase should not be underestimated and can be worked through with the help of a psychotherapist. If the tumor has been surgically removed, external stimuli in the form of direct sunlight, extreme heat or drafts must be avoided at all costs.
Prevention
With regard to potential methods and measures for the prevention of cerebellopontine angle tumors, there is still no profound knowledge. Because the causes of the development of cerebellopontine angle tumors are still largely unclear. As a result, there are currently no effective measures to prevent the disease.
For this reason, it is of great importance to take advantage of the possibility of regular check-ups. Any complaints and typical symptoms of cerebellopontine angle tumors should also be presented to a doctor. Prompt diagnosis improves the chances of recovery.
Aftercare
Follow-up care is part of every cancer therapy. In this way, a new disease should be detected as early as possible and treatment initiated. Doctors expect the greatest treatment success. The situation is no different with a cerebellopontine angle tumor. Follow-up care usually takes place in the clinic of the first intervention. Immediately after healing, there is the greatest risk of a new tumor.
Therefore, the first follow-up examination takes place within three months. Then the rhythm lengthens. From the fifth year of freedom from symptoms, an annual follow-up inspection is sufficient. The statistical risk of a new disease has fallen sharply. The doctor treating you will take a detailed medical history.
Magnetic resonance imaging allows clear statements about a recurrence of the cerebellopontine angle tumor. In addition, aftercare is about everyday support and, depending on the extent of the complaint, about accompanying long-term treatment. Therapy can cause complications. Vision can be limited or paralysis can occur.
Neurological and psychological disorders are also encountered. The best way to deal with the difficulties is with a rehabilitation measure. The patient is also given the correct medication. The cerebellopontine angle tumor can also lead to questions about one’s own life, which are then discussed in psychotherapy.
You can do that yourself
A cerebellar pontine angle tumor is often symptom-free for many years and is easily treatable. The most important measure is to comply with the doctor’s prescriptions regarding medication and diet. In the case of symptoms that limit performance, a sick note from the family doctor may be indicated. In general, the sick should take it easy and focus on relieving the symptoms.
In the case of hearing problems, a hearing test must be carried out at an early stage. The patient may need a hearing aid temporarily . Those affected often suffer from symptoms such as dizziness and balance disorders. In order to avoid accidents, activities such as driving a car or demanding work should be avoided. Since the symptoms mainly occur in poor lighting, a sufficiently bright light source should always be available. Larger tumors can affect facial muscles and cause grimacing. This can represent a psychological burden that should be dealt with therapeutically.
In the case of pain, in addition to the prescribed medicines, there are also natural remedies and conservative remedies, such as soothing teas or cool compresses. After the tumor has been removed, the affected ear must not be exposed to any stimuli such as drafts or excessive heat in order not to endanger the healing of the wound. The doctor in charge can often recommend further self-help measures to those affected.
