Skip to main content
Log in

Experience with 36 surgical cases of petroclival meningiomas

  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

Thirty-six patients with petroclival meningiomas underwent surgery between 1978 and 1990. The tumours accounted for 13% of a total of 284 skull base meningiomas operated upon during the same time period. The most frequent neurological signs related to cranial nerve deficits, mainly of the 8th, 5th, and 7th nerves respectively. The approaches to the petroclival region were: retromastoid, pterional, subtemporal, and combined retromastoid-subtemporal. In 12 patients we used a modification of the retromastoid-subtemporal approach with preservation of the sigmoid and transverse sinus (presigmoid approach). “Total” tumour removal was achieved in 27 cases (75%). There was no postoperative death, and in 83% of cases no severe morbidity. With careful pre-operative evaluation, improved operative approaches and microsurgical techniques the treatment of petroclival meningiomas has been considerably improved.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Al-Mefty O, Fox JL, Smith RR (1988) Petrosal approach for petroclival meningiomas. Neurosurgery 22: 510–517

    PubMed  Google Scholar 

  2. Albers FWJ (1991) Lateral sinus thrombosis and computed tomography: the empty delta sign. ORL 53: 45–47

    PubMed  Google Scholar 

  3. Castellano F, Ruggiero G (1953) Meningiomas of the posterior fossa. Acta Radiol [Suppl] (Stockh) 104: 1–157

    Google Scholar 

  4. Cherington M, Schneck SA (1966) Clivus meningiomas. Neurology 16: 86–92

    PubMed  Google Scholar 

  5. Guthrie BL, Ebersold MJ, Scheithauer BW (1991) Neoplasms of the intracranial meninges. In: Youmans JR (ed) Neurological Surgery, 3rd Ed, Vol 5. Saunders, Philadelphia, pp 3250–3315

    Google Scholar 

  6. Hakuba A, Nishimura S, Jang BJ (1988) A combined retroauricular and preauricular transpetrosal transtentorial approach to clivus meningiomas. Surg Neurol 30: 108–116

    PubMed  Google Scholar 

  7. Hakuba A, Nishimura S, Tanaka K, Kishi H, Nakamura T (1977) Clivus meningiomas: six cases of total removal. Neurol Med Chir (Tokyo) 17: 63–77

    Google Scholar 

  8. Kawase T, Shiobara R, Toya S (1991) Anterior transpetrosaltranstentorial approach for sphenopetroclival meningiomas: surgical method and results in 10 patients. Neurosurgery 28: 869–876

    PubMed  Google Scholar 

  9. Mayberg MR, Symon L (1986) Meningiomas of the clivus and apical petrous bone: report of 35 cases. J Neurosurg 65: 160–167

    PubMed  Google Scholar 

  10. Mirzai S, Tatagiba M, Samii M (1992) Posterior fossa blood flow in cerebello-pontine angle tumors. In: Yonas H (ed) Cerebral blood flow with stable xenon-CT. Raven Press, New York, pp 228–232

    Google Scholar 

  11. Samii M, Ammirati M (1988) The combined supra-infratentorial presigmoid sinus avenue to the petro-clival region. Surgical technique and clinical applications. Acta Neurochir (Wien) 95: 6–12

    Google Scholar 

  12. Samii M, Ammirati M, Mahran A, Bini W, Sepehrnia A (1989) Surgery of petroclival meningiomas: report of 24 cases. Neurosurgery 24: 12–17

    PubMed  Google Scholar 

  13. Samii M (1986) Neurosurgical aspects of processes at the tentorium margin. In: Samii M (ed) Surgery in and around the brain stem and the third ventricle. Springer, Berlin Heidelberg, pp 416–443

    Google Scholar 

  14. Sekhar LN, Samii M (1986) Petroclival and medial tentorial meningiomas. In: Scheunemann H, Schürmann K, Helms J (eds) Tumors of the skull base. Extra- and intracranial surgery of skull base tumors. Walter de Gruyter, Berlin, pp 141–158

    Google Scholar 

  15. Sen CN, Sekhar LN (1990) The subtemporal and preauricular infratemporal approach to intradural structures ventral to the brain stem. J Neurosurg 73: 345–354

    PubMed  Google Scholar 

  16. Sepehrnia A, Samii M, Tatagiba M (1991) Management of intracavernous tumours: an 11-year experience. Acta Neurochir [Suppl] (Wien) 53: 122–126

    Google Scholar 

  17. Symon L (1982) Surgical approaches to the tentorial hiatus. Adv Tech Stand Neurosurg 9: 69–112

    Google Scholar 

  18. Tatagiba M, Mirzai S, Samii M (1991) Peritumoral blood flow in intracranial meningiomas. Neurosurgery 28: 400–404

    PubMed  Google Scholar 

  19. Tatagiba M, Samii M, Matthies C (1991) Preservation of the semicircular canals and postoperative hearing in acoustic neurinoma surgery. Presented at the International Conference on Acoustic Neuroma, Copenhagen, Denmark, August 28, 1991

  20. Yaşargil MG, Mortara RW, Curic M (1980) Meningiomas of basal posterior cranial fossa. Adv Tech Stand Neurosurg 7: 1–115

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Samii, M., Tatagiba, M. Experience with 36 surgical cases of petroclival meningiomas. Acta neurochir 118, 27–32 (1992). https://doi.org/10.1007/BF01400723

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01400723

Keywords

Navigation