Efficacy of resection of petroclival meningiomas via modified subtemporal anterior transpetrosal approach

Abstract

Objective To investigate the efficacy of resection of petroclival meningiomas via modified subtemporal anterior transpetrosal approach. Methods Twenty-three patients with petroclival meningioma within the internal auditory canal and above the bridge grike resected by using the modified subtemporal anterior transpetrosal approach at the Department of Neurosurgery, the Second Affiliated Hospital of Nanchang University from January 2012 to June 2014 were analyzed retrospectively. Results None of the 23 patients died in this group. The tumors of 16 patients were totally resected (Simpson's classification, grade Ⅰ-Ⅱ) and those of 7 patients were subtotally resected (Simpson's classification, grade Ⅳ). They were followed up for 3 to 24 months. The tumor of 1 patient with subtotal resection increased slightly. Of the 20 patients with obvious symptoms before procedure, 13 were improved after procedure. They had transient neurological deficit after procedure, including 1 with oculomotor nerve palsy, 1 with dysphagia, 4 with facial paralysis, 4 with facial numbness, 2 with diplopia, and 2 with contralateral limb movement disorder. The symptoms were not improved significantly during follow-up period, including 1 with oculomotor nerve palsy, 4 with deafness, 2 with facial numbness, and 2 with esotropia. Conclusions Resection of petroclival meningiomas within the internal auditory canal and above the bridge grike via subtemporal anterior transpetrosal approach has certain advantages. Although some patients have neurological deficits after procedure, most of them are mild, reversible, and acceptable. Key words: Meningioma; Microsurgery; Petroclival; Subtemporal anterior transpetrosal approach