Combined Petrosal Approach for Resection of Petroclival Meningioma with Endoscopic Assistance: Operative Video and Technical Nuances

James K. Liu; Vincent N. Dodson

doi:10.1055/s-0039-1688487

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2019; 80(S 03): S292-S293
DOI: 10.1055/s-0039-1688487

Skull Base: Operative Videos

Georg Thieme Verlag KG Stuttgart · New York

Combined Petrosal Approach for Resection of Petroclival Meningioma with Endoscopic Assistance: Operative Video and Technical Nuances

James K. Liu

¹Department of Neurological Surgery, Center for Cerebrovascular and Skull Base Surgery, Rutgers University, New Jersey Medical School, Neurological Institute of New Jersey, RWJ Barnabas Health, Livingston and Newark, New Jersey, United States

,

Vincent N. Dodson

¹Department of Neurological Surgery, Center for Cerebrovascular and Skull Base Surgery, Rutgers University, New Jersey Medical School, Neurological Institute of New Jersey, RWJ Barnabas Health, Livingston and Newark, New Jersey, United States

› Author Affiliations

Abstract

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Keywords

combined petrosal - meningioma - petroclival - endoscopic

Fig. 1 (A, B) Preoperative post-gadolinium T1-weighted axial (A and B) and coronal (C) MRI demonstrates a right petroclival meningioma with severe brainstem compression and hydrocephalus. (D, E) 3-month postoperative post-gadolinium T1-weighted axial (D and E) and coronal (F) MRI demonstrates successful gross total resection of the tumor with decompression and re-expansion of the brainstem. The hydrocephalus was resolved with a ventriculoperitoneal shunt. MRI, magnetic resonance imaging.

Fig. 2 (A) Intraoperative photograph of a right combined petrosal approach displaying important anatomical landmarks. From left to right, top to bottom: middle fossa dura (MFD), superior semicircular canal (SSC), lateral semicircular canal (LSC), facial nerve (FN), posterior semicircular canal (PSC), posterior fossa dura (PFD), sigmoid sinus (SS). (B) View of the tumor situated cephalad to cranial nerves VII and VIII via the combined petrosal exposure.

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Fig. 1 (A, B) Preoperative post-gadolinium T1-weighted axial (A and B) and coronal (C) MRI demonstrates a right petroclival meningioma with severe brainstem compression and hydrocephalus. (D, E) 3-month postoperative post-gadolinium T1-weighted axial (D and E) and coronal (F) MRI demonstrates successful gross total resection of the tumor with decompression and re-expansion of the brainstem. The hydrocephalus was resolved with a ventriculoperitoneal shunt. MRI, magnetic resonance imaging.

Fig. 2 (A) Intraoperative photograph of a right combined petrosal approach displaying important anatomical landmarks. From left to right, top to bottom: middle fossa dura (MFD), superior semicircular canal (SSC), lateral semicircular canal (LSC), facial nerve (FN), posterior semicircular canal (PSC), posterior fossa dura (PFD), sigmoid sinus (SS). (B) View of the tumor situated cephalad to cranial nerves VII and VIII via the combined petrosal exposure.