Artikel
Meningiomas of the posterior petrous bone. Results in our series
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Autoren
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N. Francaviglia
- U.O. di Neurochirurgia, Ospedale “S. Elia”, Caltanissetta, Italia
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M. Maiello
- U.O. di Neurochirurgia, Ospedale “S. Elia”, Caltanissetta, Italia
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L. Pentimalli
- U.O. di Neurochirurgia, Ospedale “S. Elia”, Caltanissetta, Italia
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N. Alberio
- U.O. di Neurochirurgia, Ospedale “S. Elia”, Caltanissetta, Italia
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R. Alessandrello
- U.O. di Neurochirurgia, Ospedale “S. Elia”, Caltanissetta, Italia
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A. Morabito
- U.O. di Neurochirurgia, Ospedale “S. Elia”, Caltanissetta, Italia
| Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: We carried out a retrospective analyseis of our series following excision of meningiomas of the posterior aspect of the petrous bone.
Methods: From January 2000 to September 2007, 11 patients underwent removal of a posterior petrous meningiomas at our centre. According to the anatomical relationship with the posterior surface of the petrous bone and with reference to the internal auditory canal (IAC), posterior petrous meningiomas were classified into 1. Located laterally to the IAC (3 cases); 2. Located medially to the IAC, which may extend to the cavernous sinus and clivus (3 cases); and 3. Attached to the posterior surface of the petrous bone, which may envelop the seventh and eighth cranial nerves (5 cases). Surgical approaches were suboccipital, combined infratentorial-supratentorial and subtemporal-transtentorial. Symptoms, preoperative evaluation, surgical treatments, postoperative complications and patient outcomes were analyzed. Seven women and four men underwent surgery (mean age: 58.7). The main presenting symptoms were balance disorders (70%) and sensorineural hearing loss (52.5%). A preoperative facial nerve paresis was present in 2 patients.
Results: Tumor removal was complete in 80% of cases. At 1-year post-op, 8 of patients had a normal facial function and 10 had serviceable hearing. A cerebrospinal fluid leakage occurred in 1 case. Posteriorly attached meningiomas are less symptomatic and of better prognosis than medially inserted ones.
Conclusions: Our approaches were reliable for the removal for all types of such tumors. They offered low morbidity and a high proportion of facial nerve and hearing preservation. The primary principles in dealing with these tumors include preservation of vital vascular and central nervous system structures and total resection of the tumor as much as possible. Subtotal removal is also preferable in the face of the absence of a plane of cleavage between the tumor and the brainstem and in the presence of encasement of vital neurovascular structures.
