• W Zhu, Y Mao, L-F Zhou, R Zhang, and L Chen.
• Department of Neurosurgery, Huashan Hospital of Fudan University, Shanghai Neurosurgical Center, Shanghai, P.R. China.
• Minim Invas Neurosur. 2007 Apr 1;50(2):106-10.

ObjectiveResection of petroclival meningiomas offers great challenges to the neurosurgeons. Our experience of 7 cases using a combined subtemporal and retrosigmoid keyhole approach surgery was evaluated for the treatment of extensive petroclival meningiomas.MethodsFrom July 2002 to July 2005, resections of 7 petroclival meningiomas, which involved both supra- and infratentorial regions, were performed via a combined subtemporal and retrosigmoid keyhole approach. The extent of tumor resection was evaluated by MRI 3 months after surgery, and postoperative complications were investigated.ResultsThe maximum diameter of the tumors ranged from 3.4 to 6.0 cm (mean: 4.4 cm). Gross total resection (GTR) was achieved in 3 cases, giving a GTR rate of 43%. Subtotal resection (STR) was carried out in 4 cases. Neurological status remained intact in one case, while others presented with cranial nerve deficits (VII, VI, V, III and lower CN). No death was reported in the cases during the postoperative period.ConclusionThe combined keyhole approach is suitable for the treatment of extensive petroclival meningiomas. It provides easy and quick access to the supra- and infratentorial juxtaclival region without any petrous bone drilling. Complications related to the approach can be minimized.

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