Intradural Subtemporal Anterior Transpetrosal Approach For Petroclival Lesions

Objective To improve total resection rate and decrease postoperative complications of petroclival tumors by summarizing the methods and experiences of intradural subtemporal anterior transpetrosal approach for petroclival lesions.Methods The clinical data and follow-up result 10 cases with petroclival lesions who were treated via intradural anterior transpetrosal approach were retrospectively analyzed in department of neurosurgery in The first affiliated hospital of Nanjing medical university.Results In this group,there were 10 cases with middle-upper petroclival tumors including 4 meningiomas and 6 schwannomas,total resection was achieved in 9 patients and subtotal resection in 1 patient.No death occurred in these cases.The preoprative symptoms disappeared in 6 patients and relieved in 4 patients.The transient neurological deficit includes temporary mild facial palsy in 2 cases with trigeminal neurinomas,2 cases with facial pain occurred facial numbness after surgery.All the patients were follow-up in 3 to 24 monthes and no one relapse.Conclusion The intradural approach tailors the extent of anterior petrosectomy individually and shorten operating time compared with the epidural one.During opration,CSF was released slowly from the base of the middle fossa and the ambient cistern to increase surgical space.To adjust the exposure of the temporal lobe base properly can lower the injury risk of temporal veins according to the position of Labbe's veins.The intradural approach is suitable for the exision of the tumors in middle-upper petroclival region.