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The pretemporal trans-cavernous trans-Meckel's trans-tentorial trans-petrosal approach: a combo skill in treating skull base meningiomas.
Chen, Shao-Ching; Lin, Chun-Fu; Liao, Chih-Hsiang; Quilis-Quesada, Vicent; Wang, Jui-To; Wang, Wei-Hsin; Hsu, Sanford P C.
Afiliación
  • Chen SC; Division of General Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Lin CF; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
  • Liao CH; Department of Surgery, Cheng Hsin General Hospital, Taipei, Taiwan.
  • Quilis-Quesada V; Division of General Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Wang JT; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
  • Wang WH; Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan.
  • Hsu SPC; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
J Neurooncol ; 146(3): 407-416, 2020 Feb.
Article en En | MEDLINE | ID: mdl-32020471
ABSTRACT

PURPOSE:

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.

METHODS:

Patients underwent surgical intervention at our institute during 2010-2018 were retrospectively reviewed. We statistically analyzed the clinical, radiological, and pathological outcomes.

RESULTS:

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 < 0.001).

CONCLUSION:

The PCMTP is effective in treating skull base meningiomas.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Base del Cráneo / Procedimientos Neuroquirúrgicos / Neoplasias Meníngeas / Meningioma Tipo de estudio: Observational_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurooncol Año: 2020 Tipo del documento: Article País de afiliación: Taiwán

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Base del Cráneo / Procedimientos Neuroquirúrgicos / Neoplasias Meníngeas / Meningioma Tipo de estudio: Observational_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurooncol Año: 2020 Tipo del documento: Article País de afiliación: Taiwán