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Petroclival Meningioma

Tanya E Sassun, Andrea G Ruggeri, Roberto Delfini
BACKGROUND: The evolution of Petroclival Meningiomas (PMs) surgical treatment has lead nowadays to a tendency to abandon complex petrous approaches and return to "less aggressive" skull base approaches. OBJECTIVE: To propose a PMs classification and establish the role of the Combined Supra-Infratentorial Presigmoid Retrolabyrinthine (CSIPR) approach in the treatment of PMs rigorously matching the anatomical definition. METHODS: A retrospective analysis was conducted of 51 cases of PMs strictly adhering to the anatomical definition, operated on from January 1990 to December 2011...
August 24, 2016: World Neurosurgery
L H Chen, Y Yang, Q Wei, Y J Li, W D Li, J B Gao, B Yu, H Zhao, R X Xu
OBJECTIVE: With the development of modern skull base minimally invasive technology mature and neural radio surgery techniques, it is necessary to re-examine the therapeutic strategy for the treatment of petroclival meningiomas. To sum up the operative experience and methods in microsurgical resection of petroclival meningiomas by the combining trans-subtemporal and suboccipital retrosigmoid keyhole approach. To explore the minimally invasive operation approach of petroclival meningiomas, to raise the removal degree and to improve the postoperative result using this approach...
February 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Walter C Jean, Daniel R Felbaum, Amjad Anaizi, Timothy R DeKlotz
The endoscopic endonasal transclival approach has been widely described for its use to resect clivus chordomas, but there have only been isolated reports of its use for petroclival meningiomas. These tumors are most often resected utilizing open transpetrosal approaches, but these operations, difficult even in the hands of dedicated skull base surgeons, are particularly challenging if the meningiomas are medially-situated and positioned mainly behind the clivus. For this subset of petroclival meningiomas, a transclival approach may be preferable...
2016: Curēus
G Chen, W W Zhai, Z Q Yu
OBJECTIVE: To investigate varying patterns of intracranial pressure(ICP)after giant meningioma resection and analyze the causes of the variation of ICP in different postoperative phases. METHODS: Clinical data, surgical approachs and the ICP monitoring data of 7 patients with giant meningioma in different positions who were admitted to the First Affiliated Hospital of Soochow University from October 2013 to July 2014 and received microsurgical resection via different approachs were analysed retrospectively...
June 28, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Caroline Hayhurst, Michael E Sughrue, Pankaj A Gore, Phillip A Bonney, Joshua D Burks, Charles Teo
AIM: Reconstruction technique advances have created renewed enthusiasm for the expanded endonasal approach (EEA). However, as with any new technique, early experiences inevitably lead to more selective use of these techniques. We reviewed our experience of the expanded endonasal endoscopic approach for skull base meningiomas and place it in context of the literature. MATERIAL AND METHODS: We performed retrospective review of all endonasal cases performed at our center for histologically proven meningioma...
2016: Turkish Neurosurgery
Ramsey Ashour, Stephen Reintjes, Michael S Park, Sananthan Sivakanthan, Harry van Loveren, Siviero Agazzi
BACKGROUND: Although intraoperative magnetic resonance imaging (iMRI) increasingly is used during glioma resection, its role in skull base surgery has not been well documented. In this study, we evaluate our experience with iMRI for skull base surgery. METHODS: Medical records were reviewed retrospectively on all neurosurgical cases performed at our institution in the IMRIS iMRI suite between April 2014 and July 2015. RESULTS: During the study period, the iMRI suite was used for 71 skull base tumors...
September 2016: World Neurosurgery
Ariyan Pirayesh, Ioannis Petrakakis, Peter Raab, Manolis Polemikos, Joachim K Krauss, Makoto Nakamura
OBJECTIVE: Despite advances in skull base surgery, surgical removal of petroclival meningiomas (PCM) still poses a considerable neurosurgical challenge with regard to postoperative morbidity and the patients' long-term outcome. Knowledge of imaging features for PCM that might help to predict common risk factors encountered with tumor resection preoperatively is limited. The aim of this study was to clarify whether MRI features of PCM might predict tumor resectability and clinical outcome...
August 2016: Clinical Neurology and Neurosurgery
Katsuhiro Mizutani, Masahiro Toda, Kazunari Yoshida
BACKGROUND: The anterior transpetrosal approach (ATPA) has been used in the resection of petroclival meningioma (PCM) for more than 20 years. Although PCM sometimes involves the petrosal vein and its preservation has been an important issue, the precise risk of petrosal vein sacrifice and subsequent venous complications associated with the use of the ATPA in patients with PCM has not yet been elucidated. METHODS: We used computed tomographic (CT) digital subtraction venography (DSV) in the retrospective analysis of the petrosal vein and its tributaries in patients with PCM before and after surgery...
September 2016: World Neurosurgery
André Beer-Furlan, Ralph Abi-Hachem, Ali O Jamshidi, Ricardo L Carrau, Daniel M Prevedello
Petroclival meningiomas are challenging lesions to manage independently of the selected surgical approach and are unique tumors in the type of pathological displacement of the surrounding anatomy. They also represent one of the most controversial entities with regard to approach selection, especially when deciding between an open versus endonasal route. When choosing an approach to the intradural portion of the petroclival region, the location of critical neurovascular structures relative to the lesion must be anticipated, including the abducens and trigeminal nerves...
December 2016: Journal of Neurosurgical Sciences
Roberto Altieri, Tetsuro Sameshima, Paolo Pacca, Emanuela Crobeddu, Diego Garbossa, Alessandro Ducati, Francesco Zenga
Petroclival meningiomas are a challenge for neurosurgeons due to the complex anatomy of the region that is rich of vessels and nerves. A perfect and detailed knowledge of the anatomy is very demanding in neurosurgery, especially in skull base surgery. The authors describe the microsurgical anatomy to perform an anterior petrosectomy based on their anatomical and surgical experience and perform a literature review. The temporal bone is the most complex and fascinating bone of skull base. The apex is located in the angle between the greater wing of the sphenoid and the occipital bone...
May 19, 2016: Neurosurgical Review
Kazuhide Adachi, Motoharu Hayakawa, Kohei Ishihara, Tukasa Ganaha, Shinya Nagahisa, Mituhiro Hasegawa, Yuichi Hirose
OBJECTIVE: To elucidate venous drainage patterns to avoid damage to the venous drainage route in the middle cranial fossa and superior petrosal sinus when employing the transpetrosal approach. METHODS: Venous drainage patterns were assessed using three-dimensional computed tomography venography in 22 hemispheres of petroclival meningioma (PCM) cases from patients who underwent primary surgery and 40 hemispheres of control cases. Intracranial venous drainage patterns were compared between control cases and PCM cases...
August 2016: World Neurosurgery
Osama Ahmed, Jonathan Walther, Krystle Theriot, Morganne Manuel, Bharat Guthikonda
Introduction The anterior petrosectomy is a well-defined skull base approach to lesions such as petroclival meningiomas, posterior circulation aneurysms, petrous apex lesions (chondrosarcomas, cholesteatomas), ventrolateral brainstem lesions, clival chordomas, trigeminal neurinomas, and access to cranial nerves III, IV, V, and VII. Methods and Materials Fourteen anterior petrosectomies on eight cadaveric heads were performed in a skull base dissection laboratory. Predissection and postdissection thin-cut computed tomography scans were obtained to compare the bone resection...
June 2016: Journal of Neurological Surgery. Part B, Skull Base
Shinya Ichimura, Satoshi Hori, Nils Hecht, Marcus Czabanka, Peter Vajkoczy
The standard anterior transpetrosal approach (ATPA) for petroclival lesions is fundamentally an epidural approach and has been practiced for many decades quite successfully. However, this approach has some disadvantages, such as epidural venous bleeding around foramen ovale. We describe here our experience with a modified technique for anterior petrosectomy via an intradural approach that overcomes these disadvantages. Five patients with petroclival lesions underwent surgery via the intradural ATPA. The intraoperative hallmarks are detailed, and surgical results are reported...
October 2016: Neurosurgical Review
Hamid Borghei-Razavi, Shunsuke Shibao, Uta Schick
No abstract text is available yet for this article.
March 2016: World Neurosurgery
Shyamal C Bir, Tanmoy Kumar Maiti, Papireddy Bollam, Anil Nanda
Objective Petroclival meningioma (PM) presents with trigeminal neuralgia (TN) in < 5% of cases. Neurosurgeons often face the dilemma of formulating a treatment protocol when TN recurs. In this study, we sought to set up a protocol in patients with PM who had a recurrent TN. Materials and Methods We performed a retrospective review of 57 patients with PM. Of the 57 patients, only 7 patients presented with TN, and six patients experienced recurrent TN. The study population was evaluated clinically and radiographically after treatment...
February 2016: Journal of Neurological Surgery. Part B, Skull Base
Jaejoon Lim, Kyunggi Cho
Various surgical approaches for the removal of meningioma and trigeminal schwannoma in the petroclival junction (PCJ) and anterior cerebellopontine area (CPA) have been described previously. In this study, we compared the surgical outcomes of the combined petrosal approach and a modified lateral supraorbital (MLSO) approach and evaluated the reliability and safety of the MLSO approach. Fifty patients underwent surgical treatment using the combined petrosal or MLSO approach between 1996 and 2011. We retrospectively analyzed the clinical data and compared the two approaches...
May 2016: Journal of Neuro-oncology
Bum Joon Kim, Deok Hee Lee, Dong-Wha Kang
No abstract text is available yet for this article.
January 2016: Journal of Stroke
B Pintea, J A Kandenwein, H Lorenzen, C Blume, F Daher, R A Kristof
OBJECTIVE: The goal of this study was to determine the impact of the location of the most frequent skull base meningioma of the posterior fossa, i.e. petroclival (PCM) and lateral posterior pyramid meningioma (LPPM) on clinical presentation, surgical treatment and treatment results. PATIENTS AND METHODS: We retrospectively reviewed a consecutive series of patients operated on for PCM (n=46) and LPPM (n=32). Uni- and multivariate analyses were performed to identify differences in clinical presentation, surgical treatment and pre-, intra- and postoperative factors of influence upon the outcome parameters: Complications rate, mortality, tumour recurrence/progress, hospital stay, Karnofsky Performance Score (KPS)...
February 2016: Clinical Neurology and Neurosurgery
Oriela Rustemi, Renato Scienza, Alessandro Della Puppa
No abstract text is available yet for this article.
March 2016: Acta Neurochirurgica
Da Li, Jie Tang, Cong Ren, Zhen Wu, Li-Wei Zhang, Jun-Ting Zhang
BACKGROUND: Petroclival meningiomas (PCMs) were once regarded as 'inoperable' due to their complex anatomy and limited surgical exposure. This study aimed to evaluate the long-term outcomes of surgically treated PCMs larger than 2 cm. METHODS: A series of 199 consecutive patients (137 females, 68.8 %) with PCMs larger than 2 cm from between 1993 and 2003 were included. The clinical charts, radiographs, and follow-ups were evaluated. RESULTS: Gross total resection (GTR) was achieved in 111 (55...
March 2016: Acta Neurochirurgica
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