open access

Vol 47, No 4 (2013)
ARTYKUŁ ORYGINALNY
Submitted: 2012-01-18
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Meningiomas of the upper and middle part of the clivus and surrounding structures: early and long-term outcome

Piotr Ładziński, Henryk Majchrzak, Wojciech Kaspera, Mariusz Maliszewski, Krzysztof Majchrzak, Michał Tymowski, Piotr Adamczyk, Bartłomiej Błaszczyk, Aleksandra Slaska-Kaspera
DOI: 10.5114/ninp.2013.36758
·
Neurol Neurochir Pol 2013;47(4):332-344.

open access

Vol 47, No 4 (2013)
ARTYKUŁ ORYGINALNY
Submitted: 2012-01-18

Abstract

Background and purpose

Meningiomas of the upper and middle parts of the clivus and surrounding structures are removed using petrosal approaches: anterior, posterior, combined and complete. The purpose of this study is to show the results of treatment of these meningiomas and to present our interpretation of the treatment strategy.

Material and methods

Twenty-six patients (17 women, 9 men) were included in the study. The neurological status of the patients was assessed before and after surgery as well as at the conclusion of the treatment. The following measurements and data were collected and recorded: approximate volume of the treated lesion, its relation to large blood vessels, cranial nerves and the brainstem, as well as tumour consistency and vascularisation.

Results

Symptoms duration ranged from 1 to 60 months (median: 16 months). In 57.7% of patients, imbalance was the predominant sign. Less frequent symptoms were: headaches, dysacusis and hemiparesis. Approximate volumes of the tumours ranged from 4 to 65 mL (mean: 32 mL). Total or subtotal resection was achieved in 73.1% of patients. The patients’ performance improved postoperatively in 34.5%, remained unchanged in 46.2% and deteriorated in 11.5% of patients. Two (7.8%) patients died after the surgery.

Conclusions

The use of petrosal approaches in the surgical treatment of meningiomas of the upper and middle parts of the clivus and the surrounding structures facilitates good or at least satisfactory neurological outcome with a high proportion of complete resections and relatively low mortality.

Abstract

Background and purpose

Meningiomas of the upper and middle parts of the clivus and surrounding structures are removed using petrosal approaches: anterior, posterior, combined and complete. The purpose of this study is to show the results of treatment of these meningiomas and to present our interpretation of the treatment strategy.

Material and methods

Twenty-six patients (17 women, 9 men) were included in the study. The neurological status of the patients was assessed before and after surgery as well as at the conclusion of the treatment. The following measurements and data were collected and recorded: approximate volume of the treated lesion, its relation to large blood vessels, cranial nerves and the brainstem, as well as tumour consistency and vascularisation.

Results

Symptoms duration ranged from 1 to 60 months (median: 16 months). In 57.7% of patients, imbalance was the predominant sign. Less frequent symptoms were: headaches, dysacusis and hemiparesis. Approximate volumes of the tumours ranged from 4 to 65 mL (mean: 32 mL). Total or subtotal resection was achieved in 73.1% of patients. The patients’ performance improved postoperatively in 34.5%, remained unchanged in 46.2% and deteriorated in 11.5% of patients. Two (7.8%) patients died after the surgery.

Conclusions

The use of petrosal approaches in the surgical treatment of meningiomas of the upper and middle parts of the clivus and the surrounding structures facilitates good or at least satisfactory neurological outcome with a high proportion of complete resections and relatively low mortality.

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Keywords

clivus, petrous pyramid, meningioma, microsurgery, skull base surgery

About this article
Title

Meningiomas of the upper and middle part of the clivus and surrounding structures: early and long-term outcome

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 47, No 4 (2013)

Pages

332-344

DOI

10.5114/ninp.2013.36758

Bibliographic record

Neurol Neurochir Pol 2013;47(4):332-344.

Keywords

clivus
petrous pyramid
meningioma
microsurgery
skull base surgery

Authors

Piotr Ładziński
Henryk Majchrzak
Wojciech Kaspera
Mariusz Maliszewski
Krzysztof Majchrzak
Michał Tymowski
Piotr Adamczyk
Bartłomiej Błaszczyk
Aleksandra Slaska-Kaspera

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