Microsurgical resection of petroclival meningiomas: choice of surgical approaches, techniques and efficacies / 中华神经医学杂志

ABSTRACT

Objective To investigate the approaches,techniques and efficacies ofmicrosurgical resection ofpetroclival meningiomas.Methods A total of 59 patients with petroclival meningiomas,admitted to our hospital from January 2003 to January 2016,were chosen in our study;single microscopic resection was performed in 55 patients (93.2％) and re-operation was performed in 4 patients (6.8％);29 times (46.0％) via retrosigmoid approach,17 times (27.0％) via tranpetrosal approach,and 17 time via subtemporal approach (27.0％) were chosen.The clinical data,radiological findings,surgical records and outcomes of patients were retrospectively analyzed,and the prognostic factors was analyzed.Results Complete resection was achieved in 31 patients (52.5％),subtotal resection in 19 (21.7％) and partial resection in 9 (15.3％).There was no death in perioperative period.Follow-up were obtained in 55 patients,and median follow-up was 42.6 months (ranged 3-131 months).Permanent neurological damage occurred in 16 patients (27％).Tumor recurred in 11 patients:6 had gamma knife radiosurgery,one had routine radiotherapy,and 4 required re-operation.Two patients died of tumor recurrence/progression reoperation.In these 55 patients,42 enjoyed good prognosis and 13 had poor prognosis.The tumor sizes,brainstem edema and preoperative Kamofsky performance scale scores were unfavorable prognostic factors.Conclusion By using appropriate approaches,surgical strategies and techniques,the petroclival meningiomas can be removed with relatively favorable outcome.