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Intradural Transpetrosectomy for Petrous Apex Meningiomas
Shuo Han1, Xiao-Hua Zhang1, Dong-Hua Han2
1Department of Neurosurgery, Renji Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
Journal of Korean Neurosurgical Society
|August 9, 2019
Summary
Intradural transpetrosectomy offers successful surgical outcomes for petrous apex meningiomas (PAMs), improving patient quality of life. Careful management of key nerves and veins is crucial for avoiding complications.
Area of Science:
- Neurosurgery
- Skull Base Surgery
- Oncology
Background:
- Petrous apex meningiomas (PAMs) present significant surgical challenges due to their complex anatomical location.
- Effective surgical approaches are essential for achieving tumor resection while preserving neurological function.
Purpose of the Study:
- To evaluate the surgical results of intradural transpetrosectomy for PAMs.
- To detail the techniques for managing the superior petrous vein and greater superficial petrosal nerve during surgery.
Main Methods:
- Retrospective analysis of 16 patients with PAMs treated with intradural transpetrosectomy (February 2012 - May 2017).
- Review of patient data, surgical techniques, outcomes, and postoperative complications via clinical and telephone follow-up.
Main Results:
- Complete resection (Simpson grade I/II) achieved in 62.5% of cases; 37.5% had grade III resection.
- No mortality reported; Karnofsky Performance Status improved from 85.6 to 91.9.
- Two patients experienced recurrence and required reoperation; mean follow-up was 34.4 months.
Conclusions:
- Intradural transpetrosectomy enables complete resection of PAMs, enhancing survival and postoperative quality of life.
- Proper management of the superior petrous vein and greater superficial petrosal nerve is vital for preventing complications.
- Total removal of meningiomas within the cavernous sinus or adhered to the brainstem is achievable without postoperative complications.
