Surgical treatment of petroclival meningioma: a report of 15 cases

Objective To discuss the clinical characteristics, operative strategies and skills, and outcomes of meningioma in the petroclival region. Methods The clinical data of 15 cases with petroclival meningioma were retrospectively analyzed. Kawase approach was applied to remove the tumors in all the patients. Then Gamma knife radiotherapy was used as adjuvant therapy for most of these patients. Finally the functions of cranial nerves and the quality of life of the patients were analyzed. Results The most common symptoms were headache, dizziness, paralysis of abducens nerve, and facial numbness. Gross total resections of the tumor were achieved in 13 cases, subtotal resections in 2 cases. Twelve patients with tumor residual after operation were treated by Gamma knife radiotherapy. None of these patients died. After operation, neurological intact were found in 6 cases, oculomotor palsy in 6 cases, facial numbness in 7 cases, paralysis of abducens nerve in 4 cases. During the follow-up of 6 to 59 months (38.6 months in average), 12 patients lived a normal life, two could take care of himself, and one should be taken care of by others. Thirteen cases showed no evidence of tumor recurrence. The tumor residual were enlarged in 2 cases, and the tumor volume of one of the two patients became smaller again after Gamma knife radiotherapy. All the patients got complete recovery from paralysis of abducens nerve and facial nerve, 5 cases got partial recovery from facial numbness, minor improvement in abducens nerve deficits. Conclusion Adopting a suitable operative strategy and minimizing the neurological damage during operation can improve the postoperative outcome of patients with petroclival meningioma.