gms | German Medical Science

Objective: The surgical removal of petro-clival meningiomas is a challenge. The vicinity to the brain stem and the cranial nerves make the excision difficult. The size and the structure of the tumor influence the course of the surgery. The goal of our study is the critical evaluation of the functional results and patients’ quality of life.

Method: In a retrospective analysis, we evaluated the outcome of 100 patients that were operated on in our department. The patients were evaluated with respect to new neurological deficits, complications, quality of life, and tumor recurrence.

Results: Twenty male and 80 female patients were operated on with a median age of 59.2 years. The median size of the tumors was 18.7ccm . The most common approach was the suboccipital. Eight patients underwent a two-staged operation, using a suboccipital and a pterional or subtemporal craniotomy. Complete tumor removal was achieved in 66 patients. Tumor regrowth was observed in 9 patients with subsequent surgeries. New cranial nerves deficits occurred in up to 10%, a hemiparesis in 2 patients. One patient died because of a late pulmonary embolism. Complications included hemorrhage, infarction, hydrocephalus, and wound infection. The GOS 4 and 5 was achieved in 87%.

Conclusions: Surgery of petro-clival meningiomas is accompanied by a high percentage of complications; thus the indication for appropriate treatment is crucial. However, progressive tumors have to be removed and patients have to be strictly informed about possibly permanent neurological deficits and restrictions of quality of life after surgery.