Analysis of subtotal resection strategy in treating petroclival meningiomas via retrosigmoid approach

Abstract

Objective To explore optimal resection goals of petroclival meningiomas resected via retrosigmoid approach for improving quality life of patients after operation. Methods A total of 39 cases with petroclival meningiomas who underwent microsurgical removal via retrosigmoid approach from January 2006 to December 2013 in our hospital were retrospectively analyzed. Results Gross total resection was performed in 11 patients (28.21% ), and subtotal resection was performed in 28 patients (71.79% ). The occurrence rate of new cranial nerve injury or aggravated original cranial nerve injury in gross total resection group was significantly higher than that in subtotal resection group [6 patients (6/11) vs 4 patients (14.29%), Fisher exact probability: P = 0.017]. Postoperative Karnofsky Performance Status (KPS) score in gross total resection group was significantly lower than that in subtotal resection group [(72.00 ± 9.19) score vs (82.69 ± 10.41) score; t = -2.844, P = 0.007]. There was no significant difference between 2 groups on the recurrence and/or progression rate after operation (Fisher exact probability: P = 0.545). There was no significant difference of the recurrence and/or progression rate between with or without gamma knife radiosurgery (GKRS) after operation in subtotal resection group (Fisher exact probability: P = 0.529).  Conclusions Subtotal resection via retrosigmoid approach with or without gamma knife radiosurgery is reasonable and feasible strategy in the treatment of petroclival meningiomas.

DOI: 10.3969/j.issn.1672-6731.2016.12.010