Effect analysis of different surgical approaches for petroclival meningiomas

doi:10.3877/cma.j.issn.2095-123X.2022.01.006

Abstract

Abstract:

Objective

To investigate the efficacy of microsurgery on petroclival meningiomas.

Methods

The clinical data of 76 patients with petroclival meningioma admitted to the Department of Neurosurgery, the First Affiliated Hospital of Sun Yat-Sen University from June 2013 to June 2020 were retrospectively analyzed. The effects and complications of different surgical approaches were compared.

Results

Among 76 cases of petroclival meningiomas, 42 cases (55.3%) were totally resected, 28 cases (36.8%) were subtotally resected, and 6 cases (7.9%) were partially resected. Postoperative pathology showed 71 (93.4%) WHO grade Ⅰ meningiomas and 5 (6.6%) WHO grade Ⅱ meningiomas. The sugical complication included 26 cases of cranial nerve injury, 2 cases of brain stem injury, 4 cases of cerebrospinal fluid leakage and 5 cases of intracranial infection. The average preoperative Karnofsky performance status (KPS) score was 73.6±8.7. The average KPS score at 6 months after operation was 79.7±8.8. The average KPS score at 6 months after operation was better than that pre-operation (P<0.05). For different approaches, the intraoperative blood loss in the infratemporal group was more than that in the retrosigmoid group (P<0.05), and the total resection rate was higher than that in the retrosigmoid group (P<0.05).

Conclusion

Most of petroclival meningiomas are benign tumors. Most of petroclival meningiomas can be totally or subtotally removed by careful microsurgery. Although the intraoperative blood loss of infratemporal approach was more than that of retrosigmoid approach, the total resection rate was higher.

Key words: Petroclival region, Meningioma, Microsurgery, Clinical efficacy

Baoshu Xie, Kejun He, Xixi Li, Lixuan Yang, Zhengsong Huang, Nu Zhang. Effect analysis of different surgical approaches for petroclival meningiomas[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2022, 12(01): 38-42.

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URL: https://zhnkjbykfzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-123X.2022.01.006

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Figures/Tables 2

References 14

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资料	颞下组（n=35）	乙状窦后组（n=27）	χ²/t值	P值
性别（男/女）	7/28	6/21	0.045	0.831
年龄（岁，Mean±SD）	52.5±11.7	51.8±11.2	0.238	0.813
肿瘤直径（cm，Mean±SD）	3.3±1.2	3.2±1.1	0.227	0.822
手术时间（min，Mean±SD）	474.3±136.2	443.3±151.7	0.871	0.387
术中出血量（mL，Mean±SD）	454.3±202.3	277.8±115.5	4.048	<0.010
肿瘤全切[例（%）]	25（71.4）	12（44.4）	4.612	0.032
脑脊液漏[例（%）]	3（8.6）	0（0）	2.432	0.119
颅内感染[例（%）]	3（8.6）	1（3.7）	0.598	0.439
颅神经受损[例（%）]	13（37.1）	9（33.3）	0.097	0.756

资料	颞下组（n=35）	乙状窦后组（n=27）	χ²/t值	P值
性别（男/女）	7/28	6/21	0.045	0.831
年龄（岁，Mean±SD）	52.5±11.7	51.8±11.2	0.238	0.813
肿瘤直径（cm，Mean±SD）	3.3±1.2	3.2±1.1	0.227	0.822
手术时间（min，Mean±SD）	474.3±136.2	443.3±151.7	0.871	0.387
术中出血量（mL，Mean±SD）	454.3±202.3	277.8±115.5	4.048	<0.010
肿瘤全切[例（%）]	25（71.4）	12（44.4）	4.612	0.032
脑脊液漏[例（%）]	3（8.6）	0（0）	2.432	0.119
颅内感染[例（%）]	3（8.6）	1（3.7）	0.598	0.439
颅神经受损[例（%）]	13（37.1）	9（33.3）	0.097	0.756

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