Literature DB >> 15129123

The evolution of surgical approaches for posterior fossa meningiomas.

Ted Shen1, Rick A Friedman, Derald E Brackmann, William H Slattery, William E Hitselberger, Marc S Schwartz, Laurel Fisher.   

Abstract

OBJECTIVE: To evaluate surgical outcomes for the treatment of posterior fossa meningiomas at the House Ear Clinic from 1987 to 2001. We review our current treatment algorithm and present our postoperative outcomes with attention to facial and auditory neural preservation. STUDY
DESIGN: Retrospective review.
SETTING: Tertiary care center. PATIENTS: Medical records of 71 patients who underwent posterior fossa meningioma surgery at the House Ear Clinic were reviewed. INTERVENTION: All patients had surgical removal of their meningioma via translabyrinthine, transcochlear, retrosigmoid, extended middle fossa, or combined petrosal approaches by House Ear Clinic neurotologists and neurosurgeons. MAIN OUTCOME MEASURES: Preoperative and postoperative auditory and facial nerve function data were collected. Patient and tumor characteristics including presenting symptoms, completion of tumor resection, and complications secondary to surgery were also recorded.
RESULTS: The most common presenting symptoms in this series were otologic, with hearing loss (61%), tinnitus (58%), and imbalance (58%) as the three most common. Gross total resection was achieved in 67 (94%) patients. Hearing-preservation surgery was attempted in 37 (52%) patients (68% via extended middle fossa or combined approach). Twenty-one patients with preoperative Class A hearing had follow-up audiometric data and 18 (86%) had serviceable hearing preserved. Excluding transcochlear craniotomies, 85% of patients had normal facial nerve function postoperatively. Cerebrospinal fluid leak (6%) was the most common complication.
CONCLUSIONS: Advances in microsurgical techniques have greatly changed our management of patients with posterior fossa meningiomas. These changes have reduced postoperative morbidity. Specifically, use of the anterior and posterior petrosal approaches has facilitated facial and auditory neural preservation while not compromising the extent of tumor excision.

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Mesh:

Year:  2004        PMID: 15129123     DOI: 10.1097/00129492-200405000-00031

Source DB:  PubMed          Journal:  Otol Neurotol        ISSN: 1531-7129            Impact factor:   2.311


  5 in total

1.  Treatment of Lateral Skull Base and Posterior Cranial Fossa Lesions Utilizing the Extended Middle Cranial Fossa Approach.

Authors:  Joseph P Roche; Andrew J Goates; David M Hasan; Matthew A Howard; Arnold H Menezes; Marlan R Hansen; Bruce J Gantz
Journal:  Otol Neurotol       Date:  2017-06       Impact factor: 2.311

2.  The otologic approach in the management of posterior petrous surface meningiomas.

Authors:  Vittoria Sykopetrites; Abdelkader Taibah; Gianluca Piras; Anna Lisa Giannuzzi; Fernando Mancini; Mario Sanna
Journal:  Eur Arch Otorhinolaryngol       Date:  2022-06-29       Impact factor: 2.503

3.  Subtemporal transtentorial petrosalapex approach for giant petroclival meningiomas: analyzation and evaluation of the clinical application.

Authors:  Jun Yang; Yan-Hong Liu; Shun-Chang Ma; Lin Wei; Rui-Sheng Lin; Jian-Fa Qi; Ye-Shuai Hu; Chun-Jiang Yu
Journal:  J Neurol Surg B Skull Base       Date:  2012-02

4.  Posterior cranial fossa meningiomas.

Authors:  Vijayakumar Javalkar; Anirban Deep Banerjee; Anil Nanda
Journal:  J Neurol Surg B Skull Base       Date:  2012-02

5.  Outcomes of Transzygomatic Middle Cranial Fossa Approach for Skull Base Tumors-A Single Institutional Experience.

Authors:  Nauman F Manzoor; Peter Morone; Patrick D Kelly; Silky Chotai; Robert J Yawn; Lola B Chambless; Reid C Thompson; Alejandro Rivas
Journal:  J Neurol Surg B Skull Base       Date:  2020-03-28
  5 in total

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