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Ventral petrous meningiomas: unique tumors
1Brain Tumor and Neuro-oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
Surgical Neurology
|January 17, 2009
Summary
Ventral petrous meningiomas (VPM) show distinct histology and outcomes compared to other petrous meningiomas (PM). VPM, often meningothelial, have poorer resection rates and higher complication risks like hearing loss.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- Petrous meningiomas (PM) are tumors originating from the petrous bone.
- Understanding their subtypes based on location relative to the internal auditory canal (IAC) is crucial for surgical planning.
Purpose of the Study:
- To analyze surgical outcomes and histologic subtypes of petrous meningiomas.
- To test the hypothesis that tumor origin influences histology and operative results.
Main Methods:
- Retrospective review of 58 petrous meningioma patients.
- Classification into posterior (PPM), superior (SPM), and ventral petrous (VPM) groups based on IAC proximity.
- Analysis of clinical presentation, tumor characteristics, resection extent, outcome, and histology via suboccipital retrosigmoid approach.
Main Results:
- High Simpson grade I/II resection rates: 96.6% for PPM, 100% for SPM, 57.9% for VPM.
- Histology varied by location: PPM/SPM predominantly fibrous (69%/62%), VPM predominantly meningothelial (68.4%).
- Postoperative hearing loss was a significant complication in VPM (31.6%) but not PPM/SPM.
Conclusions:
- Ventral petrous meningiomas exhibit unique histology and surgical outcomes.
- The prevalence of meningothelial histology in VPM suggests potentially different tumorigenesis.
- Ventral petrous meningiomas warrant classification as a distinct tumor group.
