Surgical Approaches for Cerebellopontine Angle/Petroclival Meningiomas

Abstract

Considering that most meningiomas are pathologically benign, tumors located in the cerebellopontine angle and petroclival area should be reduced as much as possible, and radiation therapy should be administered if necessary. Consequently, relatively good preservation of cranial nerve function and local lesion control can be expected. However, because the lesions are generally located deep, and are surrounded by various important structures, performing surgical procedures is difficult, and careful management of the surgical strategy is important to avoid complications. Surgical outcomes have dramatically improved with the development of skull base and microsurgical techniques. The main surgical approaches for cerebellopontine angle meningiomas and petroclival meningiomas currently include the anterior and posterior combined transpetrosal, anterior transpetrosal, and lateral suboccipital approaches. Furthermore, with the recent developments in endoscopic surgery, minimally invasive surgery for skull base meningiomas has gradually been introduced. In this article, we explain the preoperative checkpoints, selection of the surgical approach, and surgical techniques for the resection of cerebellopontine angle meningiomas and petroclival meningiomas.