Skip to main content
SpringerLink
Log in

Petroclival Meningiomas

  • Chapter
  • First Online:
Book cover Skull Base Surgery of the Posterior Fossa

  • 1058 Accesses

Abstract

Petroclival (PC) meningiomas are difficult-to-treat, deep-seated skull base lesions arising from the petroclival synchondrosis with close proximity to vital neurovascular structures. Their management has undergone paradigm shifts over the past few decades that span from radical resection to more tailored surgical decompression that offers deficit-free survival. These changes have been enabled by the advent of modern microneurosurgical skull base techniques, better understanding of the surgical anatomy, and availability of intraoperative neurophysiological monitoring and efficacious adjuvant therapy option such as stereotactic radiosurgery (SRS) in the armamentarium of modern skull base neurosurgeon. This chapter reviews the natural history, clinical presentation, preoperative evaluation, decision-making, surgical approaches, role of SRS, and treatment outcomes in the era of multimodality management of PC meningiomas.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bambakidis NC, Kakarla UK, Kim LJ, et al. Evolution of surgical approaches in the treatment of petroclival meningiomas: a retrospective review. Neurosurgery. 2007;61(5 Suppl 2):202–9. discussion 9–11

    PubMed  Google Scholar 

  2. Hunter JB, Weaver KD, Thompson RC, et al. Petroclival meningiomas. Otolaryngol Clin N Am. 2015;48(3):477–90.

    Article  Google Scholar 

  3. Maurer AJ, Safavi-Abbasi S, Cheema AA, et al. Management of petroclival meningiomas: a review of the development of current therapy. J Neurol Surg B Skull Base. 2014;75(5):358–67.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Seifert V. Clinical management of petroclival meningiomas and the eternal quest for preservation of quality of life: personal experiences over a period of 20 years. Acta Neurochir (Wien). 2010;152(7):1099–116.

    Article  Google Scholar 

  5. Olivecrona H. The surgical treatment of intracranial tumours. In: Olivecrona H, Tonnis W, editors. Handbuch der Neurochirurgie. Springer, Berlin Heidelberg New York; 1967. p 1–301.

    Google Scholar 

  6. Campbell E, Whitfield RD. Posterior fossa meningiomas. J Neurosurg. 1948;5(2):131–53.

    Article  CAS  PubMed  Google Scholar 

  7. Hakuba A, Nishimura S, Tanaka K, et al. Clivus meningioma: six cases of total removal. Neurol Med Chir (Tokyo). 1977;17(1 Pt 1):63–77.

    Article  CAS  Google Scholar 

  8. Yasargil M, Mortara M, Curcic M. Meningioma of basal posterior cranial fossa. In: Krayenbuhl H, editor. Advances and technical standards in neurosurgery. Vienna: Springer-Verlag; 1980. p. 1–115.

    Google Scholar 

  9. Castellano F, Ruggiero G. Meningiomas of the posterior fossa. Acta Radiol Suppl. 1953;104:1–177.

    CAS  PubMed  Google Scholar 

  10. Van Havenbergh T, Carvalho G, Tatagiba M, et al. Natural history of petroclival meningiomas. Neurosurgery. 2003;52(1):55–62. discussion – 4

    PubMed  Google Scholar 

  11. Coppens J, Couldwell W. Clival and petroclival meningiomas. In: McDermott M, DeMonte F, editors. Al-Mefty’s meningiomas. New York: Thieme; 2011.

    Google Scholar 

  12. Couldwell WT, Fukushima T, Giannotta SL, et al. Petroclival meningiomas: surgical experience in 109 cases. J Neurosurg. 1996;84(1):20–8.

    Article  CAS  PubMed  Google Scholar 

  13. Adachi K, Hayakawa M, Ishihara K, et al. Study of changing intracranial venous drainage patterns in Petroclival meningioma. World Neurosurg. 2016;92:339–48.

    Article  PubMed  Google Scholar 

  14. Liu JK, Couldwell WT. Interpositional carotid artery bypass strategies in the surgical management of aneurysms and tumors of the skull base. Neurosurg Focus. 2003;14(3):e2.

    PubMed  Google Scholar 

  15. Yang T, Tariq F, Chabot J, et al. Cerebral revascularization for difficult skull base tumors: a contemporary series of 18 patients. World Neurosurg. 2014;82(5):660–71.

    Article  PubMed  Google Scholar 

  16. Kodama K, Javadi M, Seifert V, et al. Conjunct SEP and MEP monitoring in resection of infratentorial lesions: lessons learned in a cohort of 210 patients. J Neurosurg. 2014;121(6):1453–61.

    Article  PubMed  Google Scholar 

  17. Flannery TJ, Kano H, Lunsford LD, et al. Long-term control of petroclival meningiomas through radiosurgery. J Neurosurg. 2010;112(5):957–64.

    Article  PubMed  Google Scholar 

  18. Starke R, Kano H, Ding D, et al. Stereotactic radiosurgery of petroclival meningiomas: a multicenter study. J Neuro-Oncol. 2014;119(1):169–76.

    Article  Google Scholar 

  19. Almefty R, Dunn IF, Pravdenkova S, et al. True petroclival meningiomas: results of surgical management. J Neurosurg. 2014;120(1):40–51.

    Article  PubMed  Google Scholar 

  20. Borghei-Razavi H, Tomio R, Fereshtehnejad SM, et al. Anterior petrosal approach: the safety of Kawase triangle as an anatomical landmark for anterior petrosectomy in petroclival meningiomas. Clin Neurol Neurosurg. 2015;139:282–7.

    Article  PubMed  Google Scholar 

  21. Sincoff EH, McMenomey SO, Delashaw JB Jr. Posterior transpetrosal approach: less is more. Neurosurgery. 2007;60(2 Suppl 1):ONS53–8. discussion ONS8–9

    PubMed  Google Scholar 

  22. Horgan MA, Anderson GJ, Kellogg JX, et al. Classification and quantification of the petrosal approach to the petroclival region. J Neurosurg. 2000;93(1):108–12.

    Article  CAS  PubMed  Google Scholar 

  23. Horgan MA, Delashaw JB, Schwartz MS, et al. Transcrusal approach to the petroclival region with hearing preservation. Technical note and illustrative cases. J Neurosurg. 2001;94(4):660–6.

    Article  CAS  PubMed  Google Scholar 

  24. Morisako H, Goto T, Ohata K. Petroclival meningiomas resected via a combined transpetrosal approach: surgical outcomes in 60 cases and a new scoring system for clinical evaluation. J Neurosurg. 2015;122(2):373–80.

    Article  PubMed  Google Scholar 

  25. Couldwell WT, Fukushima T. Cosmetic mastoidectomy for the combined supra/infratentorial transtemporal approach. Technical note. J Neurosurg. 1993;79(3):460–1.

    Article  CAS  PubMed  Google Scholar 

  26. Shibao S, Borghei-Razavi H, Orii M, et al. Anterior transpetrosal approach combined with partial posterior petrosectomy for petroclival meningiomas with posterior extension. World Neurosurg. 2015;84(2):574–9.

    Article  PubMed  Google Scholar 

  27. Natarajan SK, Sekhar LN, Schessel D, et al. Petroclival meningiomas: multimodality treatment and outcomes at long-term follow-up. Neurosurgery. 2007;60(6):965–79. discussion 79–81

    Article  PubMed  Google Scholar 

  28. Park CK, Jung HW, Kim JE, et al. The selection of the optimal therapeutic strategy for petroclival meningiomas. Surg Neurol. 2006;66(2):160–5. discussion 5–6

    Article  PubMed  Google Scholar 

  29. Roche PH, Pellet W, Fuentes S, et al. Gamma knife radiosurgical management of petroclival meningiomas results and indications. Acta Neurochir (Wien). 2003;145(10):883–8. discussion 8

    Article  Google Scholar 

  30. Subach BR, Lunsford LD, Kondziolka D, et al. Management of petroclival meningiomas by stereotactic radiosurgery. Neurosurgery. 1998;42(3):437–43. discussion 43–5

    Article  CAS  PubMed  Google Scholar 

  31. Rowe J, Grainger A, Walton L, et al. Risk of malignancy after gamma knife stereotactic radiosurgery. Neurosurgery. 2007;60(1):60–5. discussion 5–6

    Article  PubMed  Google Scholar 

  32. Liu J, Couldwell W. Petrosal approach for resection of petroclival meningiomas. In: Badie B, editor. Neurosurgical operative atlas 2E: neuro-oncology. New York: Thieme; 2006. p. 170–9.

    Google Scholar 

Download references

Acknowledgments

We thank Kristin Kraus, MSc, our medical editor, for her contribution to manuscript editing and Vance Mortimer, our video editor, for his contribution to editing the operative videos.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India

    Amol Raheja MBBS, MCh

  2. Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA

    William T. Couldwell MD, PhD

Authors
  1. Amol Raheja MBBS, MCh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. William T. Couldwell MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Amol Raheja MBBS, MCh .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA

    William T. Couldwell

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Raheja, A., Couldwell, W.T. (2018). Petroclival Meningiomas. In: Couldwell, W. (eds) Skull Base Surgery of the Posterior Fossa . Springer, Cham. https://doi.org/10.1007/978-3-319-67038-6_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-67038-6_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-67037-9

  • Online ISBN: 978-3-319-67038-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation