2025 Poster Presentations
P156: FOUR HAND TECHNIQUE IN PETROCLIVAL MENINGIOMA SURGERY: RESULTS FROM 44 DANISH PATIENTS
Lars Poulsgaard, MD; Jacob Springborg, MD, PhD; Kaare Fugleholm Buch, MD; University Clinic of Neurosurgery, Rigshospitalet, Copenhagen
Background: Petroclival meningiomas are a rare subtype of intracranial meningiomas located at the Petroclival junction, where the petrous part of the temporal bone meets the clivus. Due to their deep-seated location and proximity to critical neurovascular structures, these tumors pose unique challenges in terms of diagnosis and treatment.
Objective: This abstract aim to review the results of surgical treatment of Petroclival meningiomas operated in the Department of Neurosurgery, University Clinic of Copenhagen, Rigshospitalet with emphasis on surgical approach and postoperative outcomes.
Methods: We conducted a retrospective study of patients operated for Petroclival meningiomas at our institution in the period 2009 to 2022. Clinical data, imaging studies, surgical techniques employed, and postoperative complications were analyzed to assess the impact of various treatment approaches on patient outcomes.
Results: A total of 44 patients with Petroclival meningiomas were reviewed. The most common presenting symptoms were trigeminal dysfunction (pain and/or sensory loss (61 %), gait disturbance (50 %), hearing loss (39 %) and fatigue, mental symptoms and headache. Surgical resection was performed using the presigmoid, retrosigmoid, subtemporal and translabyrinthine approaches or combinations of these approaches. Total tumor removal was obtained in 32 % of cases and partial removal in 68 %. Postoperatively, 68 % of patients had a stable or improvement conditions after surgery and 32 % were worse than before surgery. We had no mortality.
Conclusion: Petroclival meningiomas present significant surgical challenges due to their location and association with critical structures. Many patients with Petroclival meningiomas can be observed for many years without surgery. Surgical management is considered in cases with tumor growth or progressive symptoms.
Keywords: Petroclival meningiomas