Abstract
Background
Petroclival meningiomas are challenging tumors. Several skull base approaches have been proposed in the last decades, with variable rates of postoperative morbidity and extent of resection.
Methods
We herein reported the step-by-step microsurgical resection of a large petroclival meningioma through an extended retrosigmoid approach. Detailed surgical technique has been accompanied by a 2D operative video.
Conclusion
The extended retrosigmoid approach allowed for a safe gross total resection of the tumor, as confirmed by the postoperative MRI. The patient did not experience any new postoperative deficit, despite a transient diplopia, and was discharged on postoperative day 7.
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Abbreviations
- AICA:
-
Anterior inferior cerebellar artery
- BA:
-
Basilar artery
- CSF:
-
Cerebrospinal fluid
- CN:
-
Cranial nerve
- CT:
-
Computed tomography
- eRS:
-
Extended retrosigmoid
- EVD:
-
External ventricular drainage
- IONM:
-
Intraoperative neuromonitoring
- MRI:
-
Magnetic resonance imaging
- PCM:
-
Petroclival meningioma
- PICA:
-
Posterior inferior cerebellar artery
- SCA:
-
Superior cerebellar artery
- VA:
-
Vertebral artery
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Beatrice Claudia Bono MD: second surgeon, conceptualization, data collection and curation, original draft preparation, writing-reviewing, video editing. Francesca Faedo MD: third surgeon, digital drawings, data curation. Marco Riva MD: supervision and reviewing of the final manuscript version, video voiceover. Federico Pessina MD: first surgeon, supervision, and reviewing of the final manuscript version.
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The patient was treated under the principles of the Helsinki Declaration, and the local ethics committee.
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Bono, B.C., Faedo, F., Riva, M. et al. Microsurgical resection of a large petroclival meningioma through an extended retrosigmoid approach: how I do it. Acta Neurochir 166, 178 (2024). https://doi.org/10.1007/s00701-024-06073-3
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DOI: https://doi.org/10.1007/s00701-024-06073-3