[Petrous bone approach for the surgery of petroclival meningiomas]

Four patients, 3 woman and 1 man, with giant petroclival meningiomata are presented. In all cases the tumor size exceed 44 mm in its greater diametre. Main clinical symptoms were endocranial hypertension and cranial nerves deficit. A modified transcochlear approach in two stages was used. A total petrosectomy was performed, using the petrosygmoidal via for opening the dura. Transversus and sygmoid sinus were spared. Total removal was achieved in 2 cases, subtotal and partly in each of the other 2. No operative mortality occurred (hospital exitus) and neurologic morbility related to V-VI-VII and VIII cranial nerves and 1 hemyparesia was recorded. The AA. explain and comment the fundamentals of the followed procedure and compare, as well, the own outcomes with those reported by more classic alternatives. Finally, the conclusion is drawn out that retroclival meningiomata are conditions treatable, although always are difficulty approached and demand meticulous microsurgical techniques.