gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Impact of the petrosal vein sectioning on postoperative auditory function in surgery of meningiomas involving the petrous apex

Der Einfluss der Vena petrosa auf die postoperative Hörfunktion bei Operationen von Meningeomen mit Beteiligung der Felsenbeinspitze

Meeting Abstract

  • corresponding author A. Gharabaghi - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • A. Körbel - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • A. Samii - Klinik für Neurochirurgie, International Neuroscience Institute, Hannover
  • J. Kaminsky - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • M. Tatagiba - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • M. Samii - Klinik für Neurochirurgie, International Neuroscience Institute, Hannover

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc10.05.-07.03

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0116.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Gharabaghi et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Meningiomas involving the petrous apex commonly present a close relationship with the petrosal venous complex. The superior petrosal vein drains brainstem and cerebellar veins into the superior petrosal sinus. Nonetheless, the impact of this obliteration on auditory function is still controversial in the literature. To our knowledge, there is no study available so far focusing on the occurrence of cochlear nerve dysfunction following petrosal vein coagulation.

Methods

Fifty-five patients with meningiomas involving the petrous apex and preoperative auditory function were evaluated retrospectively reviewing pre- and postoperative radiological images, surgical reports and operation videos, intensive care unit protocols, patient notes and discharge letters. The study included the following preoperative parameters: patient gender and age, location and size of the meningioma as well as the grade of brainstem compression. Pre- and postoperative auditory function was studied in terms of both pure tone and speech discrimination audiometry.

Results

Of 55 patients studied, 26 (46.4%) presented with petro-clival, 17 (30.9%) with cerebello-pontine angle, 11 (20%) with petrous apex tumors and one with a spheno-petroclival lesion.

Intraoperatively, a single superior petrosal vein was identified in 38 cases (76.4%), while two veins were observed in 13 patients (23.6%), and three or more veins could be found in two cases (3.4%). No superior petrosal vein could be identified in two cases (3.6%).

Of 53 patients with identified petrosal veins, the complete superior petrosal venous complex could be preserved in 26 cases (49.1%). In the remaining 27 cases (50.9%) at least one petrosal vein was sacrificed during surgery.

Evaluating the hearing function two weeks postoperatively, there was no significant difference between the sacrificed-vein group and the preserved-vein group, with preserved auditory function in 24 patients (88.9%) and in 23 patients (88.5%), respectively. Also, no other analyzed parameters in this study were significantly different in these two groups.

Conclusions

Superior petrosal vein sectioning during surgery of meningiomas involving the petrous apex is not associated with an increased occurrence of auditory dysfunction postoperatively. Nonetheless, preservation of the petrosal venous complex should be attempted whenever possible to avoid other complications that may be related to venous congestion.