The pretemporal trans-cavernous trans-Meckel’s trans-tentorial trans-petrosal approach: a combo skill in treating skull base meningiomas
Autor: | Jui-To Wang, Chih-Hsiang Liao, Vicent Quilis-Quesada, Shao-Ching Chen, Sanford P.C. Hsu, Chun-Fu Lin, Wei-Hsin Wang |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male Cancer Research medicine.medical_specialty medicine.medical_treatment Skull Base Neoplasms Neurosurgical Procedures Resection Meningioma 03 medical and health sciences 0302 clinical medicine Meningeal Neoplasms otorhinolaryngologic diseases Humans Medicine Olfactory Groove Aged Retrospective Studies Aged 80 and over Skin incision business.industry Pterional approach Middle Aged Microsurgery medicine.disease Progression-Free Survival Skull medicine.anatomical_structure Neurology Oncology 030220 oncology & carcinogenesis Cavernous sinus Female Neurology (clinical) Radiology business 030217 neurology & neurosurgery |
Zdroj: | Journal of Neuro-Oncology. 146:407-416 |
ISSN: | 1573-7373 0167-594X |
Popis: | Surgical treatments for skull base meningiomas are challenging. We found that most of these lesions (75%), despite locating at the anterior, middle or posterior fossa, could be dealt with a combo skill—the pretemporal trans-cavernous trans-Meckel’s trans-tentorial trans-petrosal approach (PCMTP), which adopted the same curvilinear skin incision as for the classic pterional approach. Our aim of this study is to validate the application of this technique in treating skull base meningiomas. Patients underwent surgical intervention at our institute during 2010–2018 were retrospectively reviewed. We statistically analyzed the clinical, radiological, and pathological outcomes. In total, 109 patients operated with at least part of the PCMTP combo technique were included. The median follow-up time was 26.6 months. Tumor locations were categorized into: Zone I—sphenoid ridge, olfactory groove, and juxtasellar meningiomas which could be dealt with pterional approach. Zone II—clinoidal and cavernous sinus meningiomas which could be dealt with pretemporal trans-cavernous approach. Zone III—Meckel’s and Incisura meningiomas which could be dealt with trans-Meckel’s trans tentorial approach. Zone IV—petroclival menigiomas which could be dealt with trans-petrosal approach. When an extensive tumor occupied the anterior, middle, and posterior fossa, the whole combination of the PCMTP technique was applied. The mortality rate is 3.7% (4 patients). Three patients (2.8%) suffered from postoperative deterioration and required occasional assistance. The location of tumor was associated with different Simpson grade removal (p = 0.0015) and resection rate (p |
Databáze: | OpenAIRE |
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