Aum David, Rassi Marcio S, Al-Mefty Ossama
Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
Handb Clin Neurol. 2020;170:133-141. doi: 10.1016/B978-0-12-822198-3.00035-5.
As with other meningiomas, the goal of petroclival meningioma treatment should be curative total removal by achieving a Simpson I resection of the tumor, dura, and bone. Petroclival meningiomas particularly pose a great technical challenge because of their deep location and intimate relation with vital neurovascular structures. They require adequate exposure and trajectory to achieve total removal while minimizing the manipulation and risk to critical neurovascular structures, such as the vertebrobasilar system, the brainstem, and the cranial nerves. Here, we describe the indications and technical nuances of the posterior and combined posterior-anterior petrosal approaches for petroclival meningiomas.
与其他脑膜瘤一样，岩斜区脑膜瘤的治疗目标应是通过实现肿瘤、硬脑膜和骨质的辛普森I级切除来达到根治性全切。岩斜区脑膜瘤因其位置深且与重要神经血管结构关系密切，尤其带来巨大的技术挑战。它们需要充分的显露和手术入路，以实现全切，同时将对关键神经血管结构（如椎基底系统、脑干和颅神经）的操作和风险降至最低。在此，我们描述岩斜区脑膜瘤的后入路及联合后前入路的手术指征和技术细节。
