Transpetrosal approaches for meningiomas of the posterior aspect of the petrous bone Results in 43 consecutive patients
- PMID: 17604904
- DOI: 10.1016/j.clineuro.2007.05.019
Transpetrosal approaches for meningiomas of the posterior aspect of the petrous bone Results in 43 consecutive patients
Abstract
Objective: To assess outcome following excision of meningiomas of the posterior aspect of the petrous bone through transpetrosal approaches.
Material and method: We carried out a retrospective case-series study in a multidisciplinary tertiary care center on all patients who underwent meningiomas removal from January 1989 to September 2005. Surgical approaches were transpetrosal: widened retrolabyrinthine, translabyrinthine, transotic and transcochlear, occasionally combined with a subtemporal transtentorial approach. Epidemiology, symptoms, preoperative evaluation, surgery, postoperative complications and facial and auditory results were analyzed using standardized grading systems. The Desgeorges and Sterkers classification was used to assess tumor size and location.
Results: Forty women and three men underwent surgery (mean age: 56.7). Medium-sized tumors stages 2 and 3 (84%) and AM and P localization (34% and 20.4%) predominated. In 65% of cases, the tumor extended beyond the CPA. Main presenting symptoms were balance disorders (72%) and sensorineural hearing loss (53.5%). Mortality was nil. A preoperative facial nerve paresis was present in 14% of patients. Tumor removal was complete in 79.1% of cases. At 1-year post-op, 73% of patients had a normal or subnormal facial function and 55% had serviceable hearing. A cerebrospinal fluid leakage occurred in 6.9%.
Discussion: Posteriorly attached meningiomas are less symptomatic and of better prognosis than medially inserted ones. Transpetrosal approaches are reliable for the removal for all types and sizes of such tumors, and can be easily combined in the same procedure with a subtemporal transtentorial approach to remove extensions to the clivus and tentorium. They offer low morbidity and a high proportion of facial nerve and hearing preservation.
Similar articles
-
Surgical management of jugular foramen meningiomas: a series of 13 cases and review of the literature.Laryngoscope. 2007 Oct;117(10):1710-9. doi: 10.1097/MLG.0b013e3180cc20a3. Laryngoscope. 2007. PMID: 17690614 Review.
-
[Management of cerebellopontine angle meningiomas and the posterior part of the temporal bone. Report on 44 cases].Rev Laryngol Otol Rhinol (Bord). 2005;126(2):81-9. Rev Laryngol Otol Rhinol (Bord). 2005. PMID: 16180346 Review. French.
-
Posterior petrous face meningiomas: an algorithm for surgical management.Otol Neurotol. 2007 Oct;28(7):942-50. doi: 10.1097/MAO.0b013e31814b23f0. Otol Neurotol. 2007. PMID: 17721411
-
Combined petrosal approaches in the management of temporal bone meningiomas.Otol Neurotol. 2007 Feb;28(2):236-9. doi: 10.1097/01.mao.0000244361.32073.e0. Otol Neurotol. 2007. PMID: 17159495
-
Transcochlear approach to cerebellopontine angle and clivus lesions: indications, results, and complications.Otol Neurotol. 2009 Apr;30(3):373-80. doi: 10.1097/MAO.0b013e31819a892b. Otol Neurotol. 2009. PMID: 19318889
Cited by
-
Combined presigmoid approach: A literature review.Surg Neurol Int. 2024 Sep 20;15:342. doi: 10.25259/SNI_594_2024. eCollection 2024. Surg Neurol Int. 2024. PMID: 39372980 Free PMC article. Review.
-
Predictors of hearing functional outcome following surgery for cerebellopontine angle meningioma.J Neurooncol. 2022 Mar;157(1):165-176. doi: 10.1007/s11060-022-03958-0. Epub 2022 Feb 3. J Neurooncol. 2022. PMID: 35113287
-
Facial nerve function after the extended translabyrinthine approach.J Neurol Surg B Skull Base. 2015 Feb;76(1):1-6. doi: 10.1055/s-0034-1368146. Epub 2014 Aug 11. J Neurol Surg B Skull Base. 2015. PMID: 25685642 Free PMC article.
-
Surgical Resectability of Skull Base Meningiomas.Neurol Med Chir (Tokyo). 2016 Jul 15;56(7):372-8. doi: 10.2176/nmc.ra.2015-0354. Epub 2016 Apr 14. Neurol Med Chir (Tokyo). 2016. PMID: 27076382 Free PMC article. Review.
-
Posterior petrous bone meningiomas: surgical experience in 53 patients and literature review.Neurosurg Rev. 2012 Jan;35(1):53-66; discussion 66. doi: 10.1007/s10143-011-0333-6. Epub 2011 Jun 14. Neurosurg Rev. 2012. PMID: 21670954 Review.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous