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Published on: January 17, 2018
Petroclival meningiomas: predictive parameters for transpetrosal approaches
K M Abdel Aziz1, A Sanan, H R van Loveren
1Department of Neurosurgery, University of Cincinnati College of Medicine, Ohio 45267-0515, USA.
Neurosurgery
|August 5, 2000
Summary
Anatomic parameters help predict surgical approaches for petroclival meningiomas. This study defines zones for petrosal approaches, guiding selection for safe and effective tumor excision with good patient outcomes.
Area of Science:
- Neurosurgery
- Surgical Anatomy
- Oncology
Background:
- Petroclival meningiomas pose surgical challenges due to their complex location.
- Selecting the optimal surgical approach is crucial for successful tumor resection and minimizing complications.
Purpose of the Study:
- To identify parameters influencing the choice of petrosal or combined approaches for petroclival meningioma excision.
- To correlate anatomical findings with surgical outcomes.
Main Methods:
- Dissection of 15 cadaver heads and inspection of 50 dry skulls to define anatomical zones.
- Retrospective analysis of 35 patients undergoing transpetrosal resection of petroclival meningiomas.
- Development of a grading scale for tumor resection and brainstem reexpansion.
Main Results:
- The petroclival region was divided into three zones (I, II, III) based on accessibility via different petrosal approaches.
- Total tumor excision was achieved in 37% of patients; significant brainstem reexpansion in an additional 40%.
- Postoperative cranial nerve deficits improved, with 0% mortality and acceptable morbidity.
Conclusions:
- Anatomical parameters effectively predict the resectability of petroclival meningiomas.
- Cytoreductive surgery, guided by these parameters, offers acceptable morbidity and adequate brainstem reexpansion in selected patients.
