Diagnostic and therapeutic problems in extracranial meningiomas

Abstract

Extracranial meningiomas, either primary or secondary, may present in numerous sites about the head and neck. We have described primary extracranial meningiomas of the middle ear and jugular foramen-parapharyngeal regions. Surgical extirpation of such meningiomas should provide a good prognosis if removal is complete. For tumors in the infratemporal region, preliminary total parotidectomy exposes the facial nerve so that the surrounding tumor may be removed without injuring the nerve. With patients who have extracranial extensions of intracranial meningiomas, the surgeon may be reluctant to excise the extracranial component. However, follow-up study of cases in which extracranial excision was performed suggests that long-term relief from pain and disfiguration may be expected. The intracranial component may be removed at a second-stage procedure, or in certain instances, the patient may be observed. Consultation with a neurosurgeon is essential in determining the appropriate therapeutic course. Extracranial meningiomas, either primary or secondary, may present in numerous sites about the head and neck. We have described primary extracranial meningiomas of the middle ear and jugular foramen-parapharyngeal regions. Surgical extirpation of such meningiomas should provide a good prognosis if removal is complete. For tumors in the infratemporal region, preliminary total parotidectomy exposes the facial nerve so that the surrounding tumor may be removed without injuring the nerve. With patients who have extracranial extensions of intracranial meningiomas, the surgeon may be reluctant to excise the extracranial component. However, follow-up study of cases in which extracranial excision was performed suggests that long-term relief from pain and disfiguration may be expected. The intracranial component may be removed at a second-stage procedure, or in certain instances, the patient may be observed. Consultation with a neurosurgeon is essential in determining the appropriate therapeutic course.