gms | German Medical Science

72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

Surgical and functional outcome after resection of 64 petroclival meningiomas

Chirurgisches und funktionelles Outcome nach Resektion von 64 petroclivalen Meningeomen

Meeting Abstract

  • presenting/speaker Arthur Wagner - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik, München, Deutschland
  • Amir Kaywan Aftahy - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik, München, Deutschland
  • Ann-Kathrin Jörger - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik, München, Deutschland
  • Nicole Lange - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik, München, Deutschland
  • Bernhard Meyer - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik, München, Deutschland
  • Ehab Shiban - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik, München, Deutschland
  • Chiara Negwer - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV187

doi: 10.3205/21dgnc182, urn:nbn:de:0183-21dgnc1829

Veröffentlicht: 4. Juni 2021

© 2021 Wagner et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: The management of petroclival meningiomas (PM) remains notoriously difficult due to their close association to neurovascular structures and complex anatomy. We analyzed surgical and functional outcome of a consecutive series of patients.

Methods: We reviewed patient charts and imaging data of patients with a PM resected at our institution and compared surgical and functional outcomes between subgroups stratified by surgical approach.

Results: A consecutive cohort of 64 patients from 2006 to 2018 were included, of which 67.2% were female with mean age was 55 years (range 21 – 84). Follow-up data were available for 68.8% and reached a mean 42.3 months (range 1 – 129) with a median 28.5 months. Most tumors were WHO grade I (95.3%) with an average size of 37 ± 15 mm. Infiltration of the cavernous sinus was observed in 53.1% of cases and the lesion reached the brain stem in 82.8% of cases. Preoperative cranial nerve palsy was observed in 73.4%, of which trigeminal neuropathy (42.2%), hearing loss (32.8%) and impairment of vision (18.8%) were the most common. A retrosigmoid approach was employed in 78.1% of cases, a pterional in 15.6%, combined petrosal in 3.1% and transnasal as well as subtemporal in 1.6% each. Fifteen cases (23.4%) were resected in a two-staged fashion. Gross total resection (GTR) defined as Simpson grades I and II was achieved in 71.0%, with surgical complications in 21.3% of cases most commonly constituting meningitis (6.3%). Postoperatively, 87.5% of patients had cranial nerve palsy, of which 63.6% had improved or resolved on last follow up. Trigeminal neuropathy had the highest resolution rate with 15.6%, while visual impairment only improved in 1.6% and hearing loss in 4.7%. Achieving GTR was not significantly associated with higher rates of surgical complications (p=.288) or postoperative cranial nerve palsy (p=.842). Tumor progression was observed in 15.9% of patients after a mean 102 months.

Conclusion: Despite the substantial technical challenge, resection of PMs represents the mainstay of tumor control with favourable resolution of perioperatively prevalent cranial nerve palsies.