Clear Cell Meningioma: Case Report

We report a case of clear cell meningioma in the petroclival area, occurring in a 39-year old woman. She complained of dizziness, right facial pain and ataxia. Magnetic resonance imaging performed after first operation in other hospital showed a 6x8x8cm sized slightly enhancing mass in the right petroclival area. The tumor was totally removed with petrosal approach. The clinical, radiological, histopathological, and surgical points of view are discussed.

A Case of Endolymphatic Sac Tumor / 대한이비인후과학회지

Endolymphatic sac tumor (ELST) is very rare but its aggressive papillary neoplasm destructs the temporal bone widely and often involves the intracranial structures. The most effective treatment is complete surgical removal, but it is very difficult because the character of tumor is very aggressive and extensive to the intracranial region. This tumor is not yet reported in Korea but we have recently experienced one case of ELST which we treated surgically by the traslabyrinthine/petrosal combined approach. We report the clinical and histological aspects of this rare tumor with a review of the literatures.

Modified Transpertrosal(mini-petrosal) Approach to Petroclival Tumors: Technical Note

The management of petroclival tumors has been improved by the techniques of cranial base surgery. However, these tumors are still among the most difficult cranial base lesions to treat. The t ranspetrosal approach is a routine procedure for petroclival tumors, but there are some disadvantages such as the time-consuming craniotomy during surgery. CSF leakage due to incomplete dural closure, postoperative infection, epidural hematoma and depressed deformity of the mastoid area after surgery. To solve these disadvantages, we modified the transpetrosal approach to mini-pet rosal technique involving total petrosectomy without temporal or suboccipital craniotomy. 11 petroclival tumors were operated on using this technique between August 1994 and August 1997. Gross total removal was achieved in tumors of up to 4cm diameter by this technique. The advantages of this approach are smaller skin incision, shorter operation time, and less postoperative complications such as epidural hematoma, CSF leakage infection, and headache. This technique can be indicated for medium to large petroclival tumors which do not extend to cavernous sinus and Jugular foramen.

Petrosal Approach to Petroclival Meningiomas: Experience with 3 Cases

The authors report three patients of large petroclival meningiomas which were operated by retrolabyrinthine(petrosal) approach. This technique maximizes temporal bone drilling and therefore provide exquisite exposure of the clival and petrous regions with minimal brain retraction. The superior petrosal sinus is sacrificed and the tentorium completely cut. The sigmoid sinus on the other hand can be preserved, depending on the venous drainage and the degree of exposure required.

Primary Cholesteatoma Originating in the Posterior Fossa / 대한이비인후과학회지

Primary cholesteatomas(epidermoids) originating in the posterior fossa are rare lesions that grow to a large size through slow accumulation of desquamated epithelium. These lesions grow between and ultimately displace cranial nerves, vascular structures, and the brainstem, causing a long course of progressive neurological deficits. Primary cholesteatomas are diagnosed with computed tomography and magnetic resonance imaging. The treatment of choice is surgical excision but portions of the capsule adherent to vital structures should be left undisturbed. Several approaches or combinations of approaches have been utilized to reach the lesions of the ventral brainstem. Among these, the petrosal approach has many advantages. We have experienced a huge primary cholesteatoma of the posterior fossa, so we report with review of literatures.

Direct Surgical Approach of the Spontaneous Carotid Cavernous Fistula

We report a case of spontaneous carotid cavernous fistula(CCF) showing low flow shunt, which was successfully occluded in the fistular site of CCF by direct surgical approach via anteromedial, paramedial and Parkinson's triangle intradurally through pterional subte mporal petrosal route extradurally after intermitten temporary clipping of internal corotid artery(ICA) in petrosal portion and proximal to the ophthalmic artery without hypotension, hypothermia, extracorporial circulation, or cardiac arrest.