Surgical resection renders the greatest chance for complete tumor eradication of the vast majority of CPA lesions. Occasionally, planned partial resection is considered in patients with extensive tumors associated with increased intracranial pressure. Preoperative embolization can be performed in vascular tumors to effectively decrease amount of blood loss. Diuretic therapy may provide symptomatic relief in a minority of patients with arachnoid cysts. Otherwise, options for management of lesions in the CPA include observation with serial imaging, radiation therapy, or surgery.
Chemotherapy is an option only for occasional malignant lesions.
Therapeutic embolization for vascular tumors has had limited success. While complete excision is planned for the majority, the intimate involvement of surrounding structure may impose unwarranted morbidity if complete excision is attempted. Meningiomas are excised completely more readily than epidermoids, whereas adequate therapy for arachnoid cysts is drainage. The choice of approach is based on specific location and hearing status. Occasionally, these craniotomies can be combined or performed in addition to an infratemporal fossa dissection for larger tumors.