Division of petroclival meningioma invasion and determination of its operative approach

Abstract

Objective To make a suitable surgical plan according to the sites invaded by petroclival meningionmas of skull base so as to improve the therapeutic effect. Methods We retrospectively reviewed the data of 59 cases of meningiomas in petroclival region and statistically analyzed the distribution and other features of the invasion site of petroclival meningiomas to determine their relationships with the surgical approach and their effects on degree of the tumor resection. Results In all of the 59 cases, 51 (86%), 45 (76%), 13 (22%), 19 (32%) and 28 (47%) involved in the invasion of superior petroclival region (region A), of middle petroclival region (region B), of inferior petroclival region (region C), of cerebellopontine angle region (region D) and of parasella cavernous sinus region (region E), respectively. The cases involved in 1, 2, 3, 4 and 5 distribution regions accounted for 12%, 36%, 31%, 14% and 8%, respectively. Orbitozygomatic approach was performed in 2, subtemporal approach in 7, retrosigmoid approach in 14, presigmoid approach in 33, and retrosigmoid approach plus far lateral approach in 3. Of the 59 cases, 23, 26 and 10 had been given gross total resection, near total resection and subtotal resection, respectively. Conclusion Surgical effects can be improved by choosing a suitable operative approach according to the characteristics of the division of petroclival meningioma invasion towards skull basis. Key words: Petroclival region; Meningioma; Microsurgery