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

ABSTRACT

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.