Department of Neurosurgery, The General Hospital of the Chinese PLA, 28 Fuxing Road, Haidian, Beijing 100853, China.
J Clin Neurosci. 2011 Dec;18(12):1656-61. doi: 10.1016/j.jocn.2011.03.027. Epub 2011 Oct 19.
Petroclival meningiomas are technically challenging lesions. The authors retrospectively analyzed their experience between 2000 and 2010 in 82 patients with petroclival meningioma to evaluate changes in management strategy. A total of 42 patients (51%) were treated via the retrosigmoid approach. The patients received postoperative neurological and neuroradiological follow-up. The maximum diameter of the tumors ranged from 1.5 cm to 6.5 cm (mean, 3.8 cm). Gross total resection (Simpson Grade II) was achieved in 27 patients (64%), subtotal resection (Simpson Grade III) in 11 (26%), and partial removal (Simpson Grade IV) in four (9.5%). Ten patients (24%) had new neurological deficits or worsening of pre-existing deficits. One patient (2%) died because of brainstem dysfunction after surgery. The retrosigmoid approach is suitable for treatment of selected petroclival meningioma if the main part of the tumor is located in the posterior fossa in the cerebellopontine angle and the low clivus, and only a minor part of the tumor extends to the posterior wall of the cavernous sinus. This approach provides a low degree of surgical difficulty and a low complication rate.
岩斜脑膜瘤是具有挑战性的病变。作者回顾性分析了 2000 年至 2010 年间 82 例岩斜脑膜瘤患者的治疗经验，以评估治疗策略的变化。共有 42 例（51%）患者通过乙状窦后入路治疗。患者接受术后神经和神经影像学随访。肿瘤的最大直径为 1.5 厘米至 6.5 厘米（平均 3.8 厘米）。27 例患者（64%）达到大体全切除（Simpson 分级 II），11 例（26%）次全切除（Simpson 分级 III），4 例（9.5%）部分切除（Simpson 分级 IV）。10 例患者（24%）出现新的神经功能缺损或原有缺损加重。1 例患者（2%）因术后脑干功能障碍死亡。如果肿瘤的主要部分位于桥小脑角和颅底斜坡的后颅窝，只有一小部分肿瘤延伸至海绵窦后壁，则乙状窦后入路适用于治疗选定的岩斜脑膜瘤。该入路手术难度低，并发症发生率低。
