Differences in surgical outcome between petroclival meningioma and anterior petrous meningioma

Acta Neurochir (Wien). 2021 Jun;163(6):1697-1704. doi: 10.1007/s00701-021-04753-y. Epub 2021 Feb 8.

Abstract

Background: Petroclival meningiomas (PC MNGs) and anterior petrous meningiomas (AP MNGs) have similar locations. However, these are different tumors clearly divided by the trigeminal nerve. There has never been a study on the comparison of the surgical outcomes of these two meningiomas. In this study, we compared and analyzed the surgical outcome of PC MNGs and AP MNGs.

Methods: The charts of 85 patients diagnosed with PC MNGs of AP MNGs who underwent surgical treatment were retrospectively reviewed. And we analyzed the characteristics of 49 PC MNGs (57.6%) and compared them with those of 36 AP MNGs.

Results: Preoperative brainstem edema was observed in 11 patients (22.4%) of the PC MNG group and 1 patient (2.8%) of the AP MNG group (p = 0.024). Total tumor removal was achieved in 21 patients (58.3%) of the AP MNG group, but only 17 patients (34.7%) of the PC MNG group were able to completely (p = 0.047). In addition, sixth cranial nerve palsy occurred in 17 patients (34.7%) of the PC MNG group and 4 patients (11.1%) of the AP MNG group (p = 0.025).

Conclusions: In this study, we found that PC MNGs has a worse surgical outcome than AP MNGs, because PC MNGs were difficult to completely remove and were more likely to damage abducens nerve.

Keywords: Petroclival meningioma; Petrosal approach; Petrous meningioma; Retrosigmoid intradural suprameatal approach; Skull base surgery.

MeSH terms

  • Female
  • Humans
  • Male
  • Meningeal Neoplasms / diagnostic imaging
  • Meningeal Neoplasms / surgery*
  • Meningioma / diagnostic imaging
  • Meningioma / surgery*
  • Middle Aged
  • Petrous Bone / diagnostic imaging
  • Petrous Bone / surgery*
  • Postoperative Care
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Retrospective Studies
  • Treatment Outcome