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Intradural Transpetrosectomy for Petrous Apex Meningiomas

Journal of Korean Neurosurgical Society 2019년 62권 5호 p.610 ~ 617
Han Shuo, Zhang Xiao-Hua, Han Dong-Hua, Jin Yi-Chao,
소속 상세정보
 ( Han Shuo ) - Shanghai Jiao Tong University School of Medicine Renji Hospital Department of Neurosurgery
 ( Zhang Xiao-Hua ) - Shanghai Jiao Tong University School of Medicine Renji Hospital Department of Neurosurgery
 ( Han Dong-Hua ) - Shanghai Fu Dan University School of Medicine Pudong Hospital Department of Neurosurgery
 ( Jin Yi-Chao ) - Shanghai Jiao Tong University School of Medicine Renji Hospital Department of Neurosurgery

Abstract


Objective: This study aimed to assess the surgical results of the intradural transpetrosectomy for petrous apex meningiomas (PAMs). In addition, we describe the methods and techniques used to expose and manage superior petrous vein and greater superficial petrosal nerve.

Methods: The authors conducted a retrospective study of 16 patients with PAMs operated by the senior author via the intradural transpetrosectomy between February 2012 to May 2017. We reviewed patient data regarding the general characteristics, surgical technique and surgery-related outcomes and adopted a combined follow-up strategy of clinic and telephone contacts to evaluate postoperative complications.

Results: Simpson grade I and II resection was performed in 10 out of 16 cases (62.5%), and grade III resection were reported in the remaining six cases (37.5%) with no resultant mortality. The mean Karnofsky Performance Status score was 85.6 preoperatively and improved to 91.9 postoperatively, with a mean follow-up period of 34.4 months (range, 6-66 months). Tumor recurrence was found in two patients and they underwent the second surgical operation.

Conclusion: PAMs could be completely resected by the intradural transpetrosectomy with an improved survival rate and postoperative life quality. Superior petrous vein and greater superficial petrosal nerve should be managed properly in avoidance of postoperative complications. Finally, most meningioma inside cavernous sinus or adhered to brainstem could be totally removed without postoperative complications.

키워드

Meningioma; Petrous bone; Neurosurgical procedures

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