CC BY-NC-ND 4.0 · J Neurol Surg B 2018; 79(S 05): S395-S396
DOI: 10.1055/s-0038-1669984
Skull Base: Operative Videos
Georg Thieme Verlag KG Stuttgart · New York

Resection of a Petroclival Meningioma via the Endoscope-Assisted Retrosigmoid Approach: 2-D Operative Video

Stefan Lieber
1  Department of Neurological Surgery, Eberhard-Karls University, University Hospital Tübingen, Tübingen, Germany
2  Department of Neurological Surgery, Microsurgical Neuroanatomy Lab, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
,
Rocio Evangelista-Zamora
1  Department of Neurological Surgery, Eberhard-Karls University, University Hospital Tübingen, Tübingen, Germany
,
Florian H. Ebner
1  Department of Neurological Surgery, Eberhard-Karls University, University Hospital Tübingen, Tübingen, Germany
,
Marcos Tatagiba
1  Department of Neurological Surgery, Eberhard-Karls University, University Hospital Tübingen, Tübingen, Germany
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Weitere Informationen

Address for correspondence

Stefan Lieber, MD
Department of Neurological Surgery, Eberhard-Karls University
Hoppe-Seyler-Strasse 3, D-72076 Tübingen
Germany   

Publikationsverlauf

05. Juni 2018

11. August 2018

Publikationsdatum:
01. Oktober 2018 (online)

 

Abstract

We present a case of a petroclival meningioma that was resected through an endoscope-assisted retrosigmoid approach via corridors above and below the facial-vestibulocochlear nerve complex. The patient is a 61-year-old female with complaints of left-sided hypesthesia and neuralgia of the infraorbital and zygomatic region, intermittent periorbital myokymia, and a slight facial palsy (HB II). This 2D video demonstrates the operative technique, anatomical and surgical nuances of the skull base approach and microdissection of the tumor from the critical neurovascular structures. A gross total resection was achieved. The patient’s facial and trigeminal symptoms resolved completely within a few weeks. At 2 year follow up there was no indication of residual or recurrence.

In summary, the retrosigmoid approach with endoscopic assistance is an important and powerful tool in the armamentarium for the microsurgical management of meningiomas of the lateroventral skullbase of the posterior fossa.

The link to the video can be found at: https://youtu.be/Px4XIRDoALc.


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Zoom Image
Fig. 1 Pre and postoperative MRI of the left-sided petroclival meningioma, extending from the pontomedullary junction to the tentorial incisura.
Zoom Image
Fig. 2 Illustration of the corridors used for microsurgical resection of this petroclival meningioma: (A) the corridor between the lower cranial nerves and the facial-vestibulocochlear nerve complex, (C) the corridor between the facial-vestibulocochlear nerve complex and the trigeminal nerve, (B) dissection in a human specimen for anatomical correlation.

www.thieme.com/skullbasevideos

www.thieme.com/jnlsbvideos


Qualität:

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Conflict of Interest

None.

Disclosures

None; the authors have no personal, institutional, or financial interest in any of the materials, drugs, or devices described in this article.



Address for correspondence

Stefan Lieber, MD
Department of Neurological Surgery, Eberhard-Karls University
Hoppe-Seyler-Strasse 3, D-72076 Tübingen
Germany   


  
Zoom Image
Fig. 1 Pre and postoperative MRI of the left-sided petroclival meningioma, extending from the pontomedullary junction to the tentorial incisura.
Zoom Image
Fig. 2 Illustration of the corridors used for microsurgical resection of this petroclival meningioma: (A) the corridor between the lower cranial nerves and the facial-vestibulocochlear nerve complex, (C) the corridor between the facial-vestibulocochlear nerve complex and the trigeminal nerve, (B) dissection in a human specimen for anatomical correlation.