J Neurol Surg B 2015; 76(05): 379-384
DOI: 10.1055/s-0034-1543971
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Anterior Petrosectomy: Consecutive Series of 46 Patients with Attention to Approach-Related Complications

Jamie J. Van Gompel
1  Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, United States
,
Puya Alikhani
2  Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, United States
,
A. Samy Youssef
2  Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, United States
,
Harry R. van Loveren
2  Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, United States
,
K. Paul Boyev
3  Department of Otolaryngology, University of South Florida, Tampa, Florida, United States
,
Sivero Agazzi
2  Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, United States
› Author Affiliations
Further Information

Publication History

01 September 2014

16 November 2014

Publication Date:
13 May 2015 (online)

Abstract

Objective Anterior petrosectomy(AP) was popularized in the 1980s and 1990s as micro-neurosurgery proliferated. Original reports concentrated on the anatomy of the approach and small case series. Recently, with the advent of additional endonasal approaches to the petrous apex, the morbidity of AP remains unclear. This report details approach-related morbidity around and under the temporal lobe.

Methods A total of 46 consecutive patients identified from our surgical database were reviewed retrospectively.

Results Of the 46 patients, 61% were women. Median age of the patients was 50 years (mean: 48 ± 2 years). Median follow-up of this cohort was 66 months. Most procedures dealt with intradural pathology (n = 40 [87%]). Approach-related morbidity consisted of only two patients (4%) with new postoperative seizures. There were only two significant postoperative hemorrhages (4%). Cerebrospinal fluid leakage occurred in two patients (4%) requiring reoperation.

Conclusion Approach-related complications such as seizures and hematoma were infrequent in this series, < 4%. This report describes a contemporary group of patients treated with open AP and should serve as a comparison for approach-related morbidity of endoscopic approaches. Given the pathologies treated with this approach, the morbidity appears acceptable.