gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Outcome and complications after microsurgical treatment of petroclival meningiomas

Meeting Abstract

  • J. Oberhoffer - Abteilung für Neurochirurgie der Universität Ulm am Bezirkskrankenhaus Günzburg, Deutschland
  • M.T. Pedro - Abteilung für Neurochirurgie der Universität Ulm am Bezirkskrankenhaus Günzburg, Deutschland
  • A. Jauss - Abteilung für Neurochirurgie der Universität Ulm am Bezirkskrankenhaus Günzburg, Deutschland
  • K. Seitz - Abteilung für Neurochirurgie der Universität Ulm am Bezirkskrankenhaus Günzburg, Deutschland
  • C.R. Wirtz - Abteilung für Neurochirurgie der Universität Ulm am Bezirkskrankenhaus Günzburg, Deutschland
  • G. Antoniadis - Abteilung für Neurochirurgie der Universität Ulm am Bezirkskrankenhaus Günzburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.05.05

DOI: 10.3205/12dgnc198, URN: urn:nbn:de:0183-12dgnc1984

Published: June 4, 2012

© 2012 Oberhoffer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: Petroclival meningiomas (PM) remain extremely challenging lesions to approach and to resect. Decades ago these tumors were once considered as inoperable lesions with high morbidity and mortality rate. We report our experience of patients with PM who underwent surgical treatment. We particularly focus on the neurological outcome, complications and the resection rate.

Methods: This retrospective case analysis comprises 20 patients who underwent surgery from 2003–2011. We evaluated the neurological outcome, complications, surgical approach, rate of resection and the follow-up.

Results: 15 women and 5 men with a mean age of 50.6 years were operated on. The mean time of follow-up was 25.5 (6–84) months. In 25% we could achieve total tumor resection. In 4 patients (20%) the residual tumor showed progression needing repeat resection in 2 cases. Adjuvant radiation was applied in 3 patients. The majority of patients presented with facial numbness (8 patients). Furthermore 7 patients suffered hypacusis on one side. One patient died due to postoperative general brain swelling. New postoperative cranial nerve deficits occurred in 15 patients (79%). 4 patients reported an improvement of the preexisting deficits. The most common postoperative neurological deficits were: abducens nerve palsy (5), facial nerve palsy (5), oculomotor nerve palsy (4), hypacusis (4), pituitary insufficiency (3), hemiparesis (3), leak of CSF (3), facial numbness (3) dysphagia (2) and respiratory failure (2 patients). Two patients developed hydrocephalus and required a ventriculo- peritoneal shunt. During a period of 4 months cranial nerve deficits improved significantly: facial numbness (3/3), oculomotor nerve palsy (3/4), abducens nerve palsy (2/5), facial nerve palsy (1/5) and hypacusis (1/4).

Conclusions: The advancements of neuromonitoring and microsurgical techniques have significantly improved the surgical outcome for PM. Complete surgical resection of PM is often impossible due to the involvement of cranial nerves, vertebrobasilar vessels and invasion of the brainstem. The aim of the operation should be achieving maximal tumor resection while maintaining or improving neurological function.