Surgical treatment of petroclival meningiomas: experience with 16 cases

This article presents the surgical results in a series of 16 petroclival meningiomas operated on from 1984-1990. Tumors with marked infiltration of the cavernous sinus, which belong to the category of spheno-petro-clival meningiomas, were excluded. The 16 petroclival meningiomas were all surgically treated using the combined transmastoid temporosuboccipital approach that offers a number of possible variants: retrosigmoidal, with or without recision of the sinus; presigmoidal retro-, or translabyrinthine. The choice of one or another of these variants depends on certain clinical (preoperative hearing status) and anatomic (size and extension, central or lateral, of the tumor; patency of the transverse sinuses; size and position, more or less anterior, of the sigmoid sinus; position, more or less high, of the jugular bulb) factors. The principle indications for each of these approaches are given with particular emphasis on their relative advantages and limitations.