A Modified Anterior Petrosectomy Approach for Resection of Petroclival Meningioma; with Management of Complications

• Published in: World neurosurgery 2024-07, Vol.187, p.101-101
• Main Authors: Zhang, Lei, Wang, Qi, Zhu, Junle, Luo, Chun
• Format: Article
• Language: English
• Subjects: Anterior petrosectomy; Cranial Fossa, Posterior - surgery; Female; Humans; Meningeal Neoplasms - surgery; Meningioma - surgery; Middle Aged; Neurosurgical Procedures - methods; Petroclival meningioma; Petrous Bone - surgery; Postoperative Complications - etiology; Skull Base Neoplasms - diagnostic imaging; Skull Base Neoplasms - surgery; Temporal bridging vein; Trigeminal Neuralgia - etiology; Trigeminal Neuralgia - surgery; Trochlear nerve
• ISSN: 1878-8750; 1878-8769; 1878-8769
• DOI: 10.1016/j.wneu.2024.04.044

Due to deep location and for being adjacent to neurovascular structures, petroclival meningiomas (PCMs) are generally considered to be associated with a high rate of recurrence and cranial nerve deficits.1 This video presents a 49-year-old female patient reporting right trigeminal neuralgia for more than 1 year. The incidence of this symptom with PCMs is about 5%.2 According to the classification system proposed by Kawase et al.3 and Ichimura et al.,4 this is a tentorium type PCM. A modified anterior petrosectomy approach was adopted based on the tumor size and its origin. The case presentation, surgical technique, postoperative outcome are reviewed. The treatments to the intraoperative trochlear nerve injury and temporal bridging vein occlusion are displayed (Video 1). The patient gave verbal consent for participating in the procedure and surgical video.