Surgical treatment of petroclival meningioma

Objective To raise the removal degree and to improve the postoperative result of the petroclival meningioma, its surgical strategy, the approach and the technique were probed and the factors affecting curative effect were analyzed. Methods The clinical data of consecutive 22 patients with the tumors, treated from Jan. 1989 to June 2000 in our department, were reviewed. Results Of all patients in this group, total tumor removal was achieved in 12 patients, subtotal in 6 and largely partial in 4, the cranial nerve deficit postoperatively took place in 11 patients. Of 11 patients who underwent surgical treatment via presigmoid sinus approach, total tumor removal was achieved in 8 patients, subtotal in 2 and largely partial in 1, the cranial nerve deficit postoperatively took place in 5 patients. Conclusions The petroclival meningioma is suitable for aggressive surgical treatment. The presigmoid sinus approach so far is optimal for surgical treatment petroclival meningioma. It has such advantage as shorter access, clearer exposure and more convenience to early devascularization of the tumor etc. The tumor was first cored after its devascularization. After sufficient decompression, the peripheral portion of the tumor was dissected to free the surrounding structures along the right interface, and then removed. The most important microsurgical technique is conducive to raising the removal degree and the postoperative curative effect of the tumor, and decreasing the cranial nerve deficit. Tumor size and texture, and correlation of it with adjacent structure are also the important factors affecting the curative effect of the patient with the tumor.