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Meningiomas of the upper and middle part of the clivus and surrounding structures: early and long-term outcome
Affiliations- Katedra i Oddział Kliniczny Neurochirurgii w Sosnowcu, Śląski Uniwersytet Medyczny w Katowicach
- Katedra i Klinika Laryngologii, śląski Uniwersytet Medyczny w Katowicach
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Abstract
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 methodsTwenty-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.
ResultsSymptoms 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.
ConclusionsThe 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
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 methodsTwenty-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.
ResultsSymptoms 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.
ConclusionsThe 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.
Keywords
clivus, petrous pyramid, meningioma, microsurgery, skull base surgery
About this articleTitle
Meningiomas of the upper and middle part of the clivus and surrounding structures: early and long-term outcome
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
332-344
Page views
308
Article views/downloads
716
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
