Modified Kawase approach for microsurgical removal of petroclival tumors

Abstract

Objective To discuss the outcome and surgical techniques in patients with petroclival tumors resected microsurgically via modified Kawase approach. Method 20 consecutive petroclival tumors had been resected microsurgically via modified Kawase approach. The clinical data and follow-up results were retrospectively summarized. Results In our series, there were 12 meningiomas, 5 schwannomas, 1 chordoma, 1 pontine gtioma, 1 petrosal cholesteatoma. Tumor was removed totally in 14 patients, removed subtotally in 6. There was no mortality and the main postoperative new neurological deficit was cranial nerve dysfunction. Conclusions The modified Kawase approach can provide sufficient exposure for tumors in upper petroclival region anterior to internal auditary canal. It has the advantage of early devascularization of petroclival meningioma, better visualization of the contralateral side and the ventral brainstem, less risk of venous complications, all of which facilitates safe and radical removal of the tumor. Key words: Petroclival tumor; Skull base; Microsurgery; Kawase approach