Reese, David F.

The majority of cerebellopontine angle tumors are acoustic neurinomas; however, 10% to 15% are meningiomas. Meningiomas are benign lesions that must be removed but may require surgical approaches different from those used for acoustic neurinomas. To determine if meningiomas could be distinguished from acoustic neurinomas clinically, findings in 20 patients who underwent removal of a meningioma were compared to those in 131 patients who had an acoustic neurinoma removed during the same period. We found that in patients with meningiomas the tumors frequently are large at presentation, the otologic symptoms and audiometric findings are less dramatic, and roentgenograms of the skull and tomograms of the petrous apex rarely show erosion of the internal auditory canal. Computerized tomography is the most useful method for differentiating a meningioma from a neurinoma: when a meningioma is present the characteristic finding is a broad‐based mass aligned with the petrous ridge, not centered over the internal auditory canal.

Congenital choanal atresia is rare. Previous literature has dealt with the diagnosis and management of these patients, but there are no reports that accurately describe the nature of the deformity. This is a presentation of two patients with tomographic demonstration of the abnormality which confirms the surgical descriptions of previous authors. These abnormalities are (1) narrowing of the entire nasal chamber, (2) primary bony obstruction with an area of membranous obstruction, and (3) gross deformity of the vomer.