Microsurgery via three kinds of approaches for petroclival tumors

Objective To explore the methods of microsurgery via three kinds of approaches for the petroclival tumors.Methods Of 23 petroclival tumors including 9 meningiomas, 12 neurilemmomas and 2 cholesteatomas, 11 were treated by microsurgery via thesubtemporal transtentorial approach, 7 by microsurgery via the retrosigmoid transtentorial approach and 5 by microsurgery via thecombined supra- and infratentorial approach. Therapeutic effects were evaluated by Karnofsky performance scale(KPS).ResultsThescores of KPS were(83.04±7.03) points before the operation in 23 patients with petroctival tumors, of whom, 16(69.6%) received the totalresection of the tumors, 6(26.1%) subtotal and 1(4.3%) partial. No patients died. The following-up from 6 to 36 months showed that thescores of KPS were(75.21±8.98) points 1 month after the surgery and(80.00±6.03) points 6 months after the surgery. New damage to thecranial nerve occurred due to the operation in 10 patients.ConclusionsThe subtemporal transtentorial approach, retrosigmoidtranstentorial approach and combined supra- and infratentorial approach are ideal approaches of the microsurgery for the different typesof the petroclival tumors, which can be exposed extensively with minimal injury by the microsurgery via the above-mentioned approaches.