gms | German Medical Science

Objective: The purpose of this retrospective study was to analyze the outcome and recurrence of petroclival meningiomas.

Methods: A total of 571 meningiomas were operated upon between Jan.1994 and Dec.2002. Of these, 35 were true petroclival meningiomas that were amendable for follow-up including regular outpatient follow-ups and a questionnaire.

Results: The median age of the 27 women and 8 men was 55.4 years. The patients most commonly presented with headaches, trigeminal neuralgiform pain, dizziness, ataxia, unsteadiness and hearing loss. The most frequent histology subtypes were meningothelial (16) and transitional (9) meningiomas, only one meningioma was atypical WHO°II. Intraoperative radicality was Simpson grade 2 in 14, grade 3 in 6, and grade 4 in 12 of 35 pts. Four pts. underwent two-stage operations. There was no perioperative death. Six patients suffered from CSF-flow and were treated with lumbar drainage or open revision. One post-operative VP-shunt placement, one tracheostomy, one facial nerve reconstruction were necessary. Four patients received radiation therapy of a recurrence/progression that was surgically not treatable. Post-OP morbiditiy improved with regards to hearing loss (13 pre-op, 9 post-op), trigeminal-type pain (14 pre-op vs. 2 post-op), eye movement was altered at least temporarily in 9 pts. post-op compared to 4 pre-op. Facial nerve paresis occurred in 10 pts., most of these resolved within a few months, compared to 3 pre-op patients. Operative radicality depended on location, medial structure involvement and size.

Conclusions: Petroclival meningiomas represent an entity that has a higher than usual treatment-related morbidity than meningiomas in other tumor locations.