Surgical excision of large-to-giant petroclival meningiomas focusing on the middle fossa approaches: The lessons learnt

Neurology India
Jaskaran Singh GosalArun K Srivastava

Abstract

Petroclival meningiomas are based on or arising from the petro-clival junction in upper two-thirds of clivus, medial to the fifth cranial nerve. This study focuses on the surgical experience in resecting large-giant tumors >3.5 in size predominantly utilizing middle fossa approaches. 33 patients with a large or a giant petroclival meningioma (size >3.5 cm) were included. Clinical features, preoperative radiological details, operative findings, and postoperative clinical course at the follow-up visit were reviewed. Group A tumors (n = 17,51.5%) were sized 3.5cm-5cm, and Group B (n = 16,48.48%) tumors were of size >5 cm. Extent of resection was described as 'gross total' (no residual tumor), 'near total' (<10% residual tumor) and 'subtotal resection' (>10% residual tumor). Glasgow outcome scale (GOS) quantitatively scored postoperative neurological outcome (mean follow up: 35.77months; range 1-106 months). 25 (75.8%) patients had tumour extension into both supratentorial and infratentorial compartments. Extension into Meckel's cave (n = 25,75.8%), cavernous sinus (n = 17,48.4%], sphenoid sinus (n = 12,38.7%] and suprasellar area [12,38.7%] was often seen. In 31 (93.9%) patients, the tumor crossed the midline in the premedullary, ...Continue Reading

References

Oct 21, 2015·World Neurosurgery·Oreste de DivitiisEnrico de Divitiis
May 17, 2018·Neurology India·Jeena JosephAwadhesh K Jaiswal

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Citations

Dec 21, 2019·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Jaskaran Singh GosalDeepak Kumar Jha
Oct 10, 2020·Surgical Neurology International·Jaskaran Singh GosalSudeep Khera

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