Surgical management of petroclival meningiomas invading into cavernous sinus

Abstract

To analyze the clinical features, surgical strategy and management outcomes of petroclival meningioma invading into cavernous sinus. Fifteen cases with petroclival meningioma invading into cavernous sinus were retrospectively analyzed. The presigmoidal approach was selected to remove tumors. The surgical strategy for tumor in cavernous sinus was partial resection combined with radiosurgery. Postoperative cranial nerve function and patient survival status were analyzed. The main symptoms of subtype of petroclival meningiomas were headache, abducens nerve palsy and trigeminal neuropathy. Gross total tumor removal was achieved in 13 cases and more than 90% resection in 2 cases. There was no operative death. Nine cases suffered from new postoperative cranial nerve deficits. After a follow-up of 6 - 59 months, complete improvement was achieved in oculomotor nerve deficits, much improvement in VII nerve deficit, but V and VI nerve function deficits improved slightly. The tumor progression-free survival rate was 86.7%. Rational surgical strategy to petroclival meningiomas invading into cavernous sinus should be suggested to reduce the operative morbidity and improve the survival quality of these patients.