Classification and surgical approach for tentorial meningiomas / 医学研究生学报

ABSTRACT

Objective:To explore the classification and the choice of surgical approach for tentorial meningiomas. Methods: 56 patients with tentorial meningiomas operated on between 1992 and 2002 were retrospectively analysed. According to Gkalp , there were 28 cases with medial tumor,17 cases with lateral tumor,11 cases with falcotentorial tumor. The tumors developing mainly supratentorial were approached from modified pteronal, subtemporal, temporooccipital or occipital craniotomy. For tumors developing mainly in the posterior cranial fossa, suboccipital craniectomy or combined occipital- suboccipital craniectomy was performed. The tumors developing both supratentorial and infratentorial the subtemporal-presigmoidal craniotomy were approached . Results: Total removal was achieved in 53 cases and partial removal in 3 cases. Two cases died of severe postoperative complications. The mortality rate was 3.6%. Five had additional neurological deficits postoperatively. Recurrences occurred in 6 cases. Conclusion: Surgical approach for tentorial meningiomas must be individualized for each case. The operators must master well about microanatomy of the tentorium and its specifically regional structures and expertly use microsurgical techniques for obtaining successful surgery and good outcome.