To investigate the clinical characteristics of hyperactive dysfunction syndrome (HDS) to cerebellar pontine angle (CPA) tumors and to evaluate the clinical value of microvascular decompression (MVD) after tumor resection to investigate the presence of offending vessels.

A total of 13 186 HDS patients with trigeminal neuralgia (TN), hemifacial spasm and glossopharyngeal neuralgia admitted to the Neurosurgery Department of China-Japan Friendship Hospital from January 2013 to January 2020 were retrospectively analyzed. Among them, 218 cases (1.7%) were secondary to CPA tumors. They were included in the secondary group. According to the preoperative symptoms and intraoperative exploration of the relationship between blood vessels and cranial nerves, 60 cases (27.5%) underwent MVD of trigeminal nerve, facial nerve or glossopharyngeal nerve after tumor resection. Of the 12 968 primary patients, 226 were randomly selected and included in the primary group, and all received MVD. There was no significant difference in gender and age between secondary group and primary group (P>0.05); There were significant differences in the course of disease and the proportion of cranial nerve symptoms (P<0.05). The incidence of two or more cranial nerve symptoms in the secondary group (8.3%) was significantly higher than that in the primary group (0.4%). The complication rate and recurrence rate between the two groups were compared and analyzed.

In the secondary group, TN was the most common, and the proportion of cholesteatoma was the highest (44.5%). After 2-82 months of follow-up, there was no significant difference in the remission rate and recurrence rate of cranial nerve symptoms between the two groups (P>0.05).

Patients with HDS secondary to tumors in CPA area have the characteristics of short clinical history and frequent TN symptoms. Some patients have the compression of the corresponding cranial nerves by the responsible blood vessels, MVD should be performed after tumor resection, and the postoperative symptom relief showed significant efficacy and good safety.