Microsurgical management of petroclival meningiomas

Abstract

Objective To explore the efficacy of microsurgery on petroclival meningiomas.Methods A retrospective analysis of the clinical data and the prognosis of microsurgery was performed on 21 patients with petroclival meningioma.Suboccipital retrosigmoid approach was adopted in 3 and supra-or infra-tentorial transpetrosal presigmoid approach was adopted in 18.The clinical manifestations and surgical outcomes were analyzed to evaluate the significance of microsurgery. Results Of the 21 patients with petroclival meningioma,total resection(Simpson I,Ⅱ)and sub-total resection(Simpson Ⅲ)were achieved in 11 and 5,respectively;resection of major part was obtained in 4 and partial resection was obtained in 1 with 1 postoperative death.At the early stage of postoperation,5 patients developed oculomotor palsy and 4 developed dysfunction of facial nerve;2 were found caudal cranial nerve palsy and 2 were found hemiplegia contralateral to the tumor.All these patients were followed up for about 3 months to 4 years:3 recovered from the oculomotor palsy 1 month after the operation and 3 recovered from the dysfunction of facial nerve 3 months after the operation;2 recovered from caudal cranial nerve palsy 1 week after the operation and 2 recovered from hemiplegia 1 month after the operation.5 were performed γ knife radiotherapy without tuinor recurrence. Conclusion Choosing the fight approach is the key to petroclival meningiomas management and presigmoid approach is the most effective way at present. Key words: Meningioma; Petroclival; Microsurgery; Therapy