CC BY-NC-ND 4.0 · J Neurol Surg B 2019; 80(S 03): S308-S309
DOI: 10.1055/s-0039-1677849
Skull Base: Operative Videos
Georg Thieme Verlag KG Stuttgart · New York

Staged Approach for Petroclival Meningioma Resection

Georgios Klironomos
1  Department of Neurosurgery, North Shore University Hospital at Manhasset, Manhasset, New York, United States
,
Amrit Chiluwal
1  Department of Neurosurgery, North Shore University Hospital at Manhasset, Manhasset, New York, United States
,
Amir Reza Dehdashti
1  Department of Neurosurgery, North Shore University Hospital at Manhasset, Manhasset, New York, United States
› Author Affiliations
Further Information

Address for correspondence

Georgios Klironomos, MD, MSc, PhD
Department of Neurosurgery
North Shore University Hospital at Manhasset, 300 Community Drive, Manhasset, NY 11030-3876
United States   

Publication History

27 September 2018

11 November 2018

Publication Date:
28 February 2019 (eFirst)

 

    Abstract

    Introduction Petroclival meningiomas represent very uncommon and challenging tumors. Surgical morbidity is high due to the difficult and complex approaches to this area. In the present video presentation, we demonstrate a staged-approach surgical resection for petroclival meningioma.

    Patient and Methods A 47-year- old female was incidentally diagnosed with right sizable petroclival meningioma ([Fig. 1]). The decision to proceed with a staged approach was made based on size and extension of the tumor to both the middle and posterior fossa. At the first stage we performed a right anterior petrosectomy with the patient in the supine position and the head turned 45 degrees to the left. Residual tumor was left behind along its inferior pole. At the second stage, 2 weeks after the 1st surgery, a right retrosigmoid craniotomy was performed with the patient placed on left park-bench position and the residual tumor was removed. The patient tolerated both stages very well without significant neurological deficits except a transient diplopia after the first stge. Postoperative magnetic resonance imaging (MRI) revealed gross total resection of the tumor.

    Conclusion Staged approach for petroclival meningiomas represents a safe and effective surgical management, tolerable for the patient and more comfortable for the neurosurgeon.

    The link to the video can be found at: https://youtu.be/QJJchjAwD5c.


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    Zoom Image
    Fig. 1 MRI T1 + gad demonstrates a sizable petroclival meningioma. MRI, magnetic resonance imaging.

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    Quality:

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    Conflict of Interest

    None.

    Address for correspondence

    Georgios Klironomos, MD, MSc, PhD
    Department of Neurosurgery
    North Shore University Hospital at Manhasset, 300 Community Drive, Manhasset, NY 11030-3876
    United States   

      
    Zoom Image
    Fig. 1 MRI T1 + gad demonstrates a sizable petroclival meningioma. MRI, magnetic resonance imaging.