Extent of Resection and Facial Nerve Outcome After Two-Stage Posterior Transpetrosal Surgery for Petroclival Meningiomas in Comparison to the Retrosigmoid Approach

Abstract

Objective: Management of petroclival meningiomas is challenging as they have various origins and displacement patterns, resulting in different preferences for approaches to resect them. The retrosigmoid approach has proven to be a widely versatile approach for resection of a wide variety of posterior fossa lesions, especially in the cerebellopontine angle. Its use for meningiomas in the petroclival area has also been documented in the literature with good resection rates and acceptable functional outcome. The posterior transpetrosal approach is more laborious, time consuming and with an added risk to hearing and the facial nerve, however it can provide much needed advantages for exposure and resection for meningiomas in this challenging area. The objective of this study was to compare these two approaches with regards to extent of resection and facial nerve outcome.