open access

Vol 47, No 5 (2013)
ARTYKUŁ ORYGINALNY
Submitted: 2012-07-16
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Surgical management of posterior petrous meningiomas

Arkadiusz Nowak, Tomasz Dziedzic, Andrzej Marchei
DOI: 10.5114/ninp.2013.38225
·
Neurol Neurochir Pol 2013;47(5):456-466.

open access

Vol 47, No 5 (2013)
ARTYKUŁ ORYGINALNY
Submitted: 2012-07-16

Abstract

Background and purpose

The aim of the study is to present our experience in the surgical treatment of posterior petrous meningiomas in regard to clinical presentation, surgical anatomy, complications and long-term functional postoperative results.

Material and methods

A series of 48 consecutive patients operated on for posterior petrous meningiomas at the authors’ institution between 2002 and 2011 is reported. The main symptom on first admission was hypoacusis, impairment of the fifth cranial nerve and cerebellar ataxia. The tumour was found to be attached to the premeatal dura in 46%, the inframeatal dura in 29% and the postmeatal dura in 25% of cases. Tumour resection was categorized as grade I in 16 patients, grade II in 29 patients, grade III in 1 patient and grade IV in 2 patients, according to the Simpson classification system. The petrosal approach and retrosigmoid approach were suitable for posterior petrous meningiomas.

Results

Postoperative facial nerve dysfunction appeared in 8 and further deteriorated in 2 patients. Hearing function deteriorated after surgery in 8 and improved in 2 cases. Perioperative death occurred in two patients. Tumour recurrence was observed in two patients, and both underwent a second operation and postoperative stereotactic radiotherapy.

Conclusions

Surgical treatment of posterior petrous meningiomas has become increasingly safe but these tumours still remain a surgical challenge because of the relatively high incidence of permanent complications associated with their removal. The site of displacement of the cranial nerves depending on the dural origin of the tumour has the most influence on the related difficulties in its removal.

Abstract

Background and purpose

The aim of the study is to present our experience in the surgical treatment of posterior petrous meningiomas in regard to clinical presentation, surgical anatomy, complications and long-term functional postoperative results.

Material and methods

A series of 48 consecutive patients operated on for posterior petrous meningiomas at the authors’ institution between 2002 and 2011 is reported. The main symptom on first admission was hypoacusis, impairment of the fifth cranial nerve and cerebellar ataxia. The tumour was found to be attached to the premeatal dura in 46%, the inframeatal dura in 29% and the postmeatal dura in 25% of cases. Tumour resection was categorized as grade I in 16 patients, grade II in 29 patients, grade III in 1 patient and grade IV in 2 patients, according to the Simpson classification system. The petrosal approach and retrosigmoid approach were suitable for posterior petrous meningiomas.

Results

Postoperative facial nerve dysfunction appeared in 8 and further deteriorated in 2 patients. Hearing function deteriorated after surgery in 8 and improved in 2 cases. Perioperative death occurred in two patients. Tumour recurrence was observed in two patients, and both underwent a second operation and postoperative stereotactic radiotherapy.

Conclusions

Surgical treatment of posterior petrous meningiomas has become increasingly safe but these tumours still remain a surgical challenge because of the relatively high incidence of permanent complications associated with their removal. The site of displacement of the cranial nerves depending on the dural origin of the tumour has the most influence on the related difficulties in its removal.

Get Citation

Keywords

posterior petrous meningiomas, surgical treatment, results, operative technique

About this article
Title

Surgical management of posterior petrous meningiomas

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 47, No 5 (2013)

Pages

456-466

DOI

10.5114/ninp.2013.38225

Bibliographic record

Neurol Neurochir Pol 2013;47(5):456-466.

Keywords

posterior petrous meningiomas
surgical treatment
results
operative technique

Authors

Arkadiusz Nowak
Tomasz Dziedzic
Andrzej Marchei

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