Cranial nerve preservation in surgery of the cerebellopontine angle

Surgery of the cerebellopontine angle endangers critical neurovascular structures. The variety of lesions found in this region further complicates surgical resection. The individual features of the different tumor types distort the cranial nerves in unique ways, each posing a different challenge in the effort to preserve function. Advances in the fields of microsurgery, neuroradiology, and cranial nerve monitoring have improved the rate of cranial nerve preservation considerably. This review will address the various neoplastic lesions found in this area and the current modalities used to maximize cranial nerve preservation. Emphasis is placed on surgical technique and monitoring as they undoubtedly play the most important role in efforts to preserve these structures. The success rates of those surgeons performing the largest number of these procedures is also discussed in an effort to delineate current, accepted practice.