Summary
Extradural petroclival tumours are composed of a spectrum of histological and anatomical configurations dictating a variety of surgical approaches. The experience with 68 such tumours operated at the University of Pittsburgh is presented, emphasizing the basal subfrontal and lateral approches. 85% of these tumours are benign or low-grade malignaneies, with 62% of these totally resected, resulting in a 5.4% recurrence rate. The operative mortality was 1.5% and major morbidity 3%. Well-planed surgery based on precise anatomical knowledge and imaging is the basis of treatment for petroclival tumours.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Al-Mefty O, Fox JL, Smith RR (1988) Petrosal approach for petroclival meningiomas. Neurosurgery 22: 27
Archer DJ, Young S, Uttley D (1987) Basilar aneurysms: a new transclival approach via maxillotomy. J Neurosurg 67: 54
Austin-Seymour M, Munzenrider J, Goiten M, et al (1989) Fractionated proton radiation therapy or chordoma and low-grade chondrosarcoma of the base of the skull. J Neurosurg 70: 13–17
Cocke EW, Robertson JH, Robertson JT, et al (1990) The extended maxillotomy and subtotal maxillectomy for excision of skull base tumors. Arch Otolaryngol Head Neck Surg 116: 92–104
Crockard HA, Bradford R (1985) Transoral transclival removal of a schwannoma anterior to the craniocervical junction. J Neurosurg 62: 293
Goldenberg RA (1984) Surgeon’s view of the skull base from the lateral approach. Laryngoscope 94: 1–21
Derome PJ, Visot A, Monteil JP, Maestro JL (1987) Management of cranial chordomas. In: Sekhar LN, Schramm VL Jr (eds) Tumors of the cranial base: diagnosis and treatment. Futura, New York, pp 607–622
Erba SM, Horton JA, Latchaw RE, et al (1988) Balloon test occlusion of the internal carotid artery with xenon CT cerebral blood flow imaging. AJNR 9: 533
Fisch U, Kumar A (1985) Infratemporal surgery of the skull base. In: Rand RW (ed) Microsurgery, 3rd ed. CV Mosby, St. Louis
House WF, Hitselberger WE (1976) The trans-cochlear approach to the skull base. Arch Otolaryngol 102: 334
Janecka IP, Sen CN, Sekhar LN, Arriaga (in press) Facial translocation. A new approach to the cranial base. Otolaryngol Head Neck Surg
Jones NF, Schramm VL, Sekhar LN (1987) Reconstruction of the cranial base following tumour resection. Br J Plast Surg 40: 155
King TT, Morrison AW (1990) Primary facial nerve tumors within the skull. J Neurosurg 72: 1–8
Lang J (1987) Middle cranial base anatomy. In: Sekhar LN, Schramm VL, Jr (eds) Tumors of the cranial base: diagnosis and treatment. Futura, New York, p 313
Lang J (1987) Posterior cranial base anatomy. In: Sekhar LN, Schramm VJ, Jr (eds) Tumors of the cranial base: diagnosis and treatment. Futura, New York, pp 441–460
Miller E, Crockard HA (1987) Transoral transclival removal of anteriorly placed meningiomas at the foramen magnum. Neurosurgery 20: 966
Mullan S, Naunton R, Hekmat-panah J, Vailati G (1966) The use of an anterior approach to ventrally placed tumors in the foramen magnum and vertebral column. J Neurosurg 24: 536
Sano K, Kinko M, Saito I (1966) Vertebro-basilar aneurysms, with special reference to the transpharyngeal approach to the basilar artery aneurysm. Brain Nerve (Tokyo) 18: 1197
Sekhar LN, Janecka IP, Jones NF (1988) Subtemporal-infratemporal and basal subfrontal approach to extensive cranial base tumors. Acta Neurochir (Wien) 92: 83
Sekhar LN, Jannetta PJ, Burkhart LE, et al (in press) Meningiomas involving the clivus: a 6-year experience with 38 patients. J Neurosurg
Sekhar LN, Schramm VL Jr, Jones NF (1987) Operative management of large neoplasms of the lateral and posterior cranial base. In: Sekhar LN, Schramm VL Jr (eds) Tumors of the cranial base: diagnosis and treatment. Futura, New York, pp 655–682
Sekhar LN, Schramm VL Jr, Jones NF (1987) Subtemporal- preauricular infratemporal fossa approach to large lateral and posterior cranial base neoplasms. J Neurosurg 67: 488
Sekhar LN, Schramm VL Jr, Jones NF, et al (1986): Operative exposure and management of the petrous and upper cervical internal carotid artery. Neurosurgery 19: 967
Sekhar LN, Sen CN (1989) Anterior and lateral basal approaches to the clivus. Contem Neurosurg 11: 1–8
Sen CN, Sekhar LN (in press) An extreme lateral approach to intradural lesions of the cervical spine and foramen magnum. Neurosurgery
Sen CN, Sekhar LN, Schramm VL Jr, et al (1989) Chordoma and chondrosarcoma of the cranial base: an 8-years experience. Neurosurgery 25: 931–941
Snyderman CH, Janecka IP, Sekhar LN, et al (1990) Anterior cranial base reconstruction: role of galeal and pericranial flaps. Laryngoscope 100: 49
Yasui T, Hakuba A, Kim SH, et al (1989) Trigeminal neurinomas: operative approach in eight cases. J Neurosurg 71: 506–511
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1991 Springer-Verlag
About this paper
Cite this paper
Sekhar, L.N., Pomeranz, S., Sen, C.N. (1991). Extradural Petrous Bone and Petroclival Neoplasms. In: Koos, W., Richling, B. (eds) Processes of the Cranial Midline. Acta Neurochirurgica Supplementum, vol 53. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9183-5_29
Download citation
DOI: https://doi.org/10.1007/978-3-7091-9183-5_29
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-9185-9
Online ISBN: 978-3-7091-9183-5
eBook Packages: Springer Book Archive