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Retrosigmoid Intradural Suprameatal Approach for Petroclival Meningioma

Background  Anterior transpetrosal approach and the combined transpetrosal approach are the major surgical approaches for petroclival meningiomas. However, anterior petrosectomy is not preferable in cases with postoperative venous drainage disorder of the sylvian vein due to anatomical variations. H...

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Autores principales: Ishi, Yukitomo, Terasaka, Shunsuke, Motegi, Hiroaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2019
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534698/
https://www.ncbi.nlm.nih.gov/pubmed/31143599
http://dx.doi.org/10.1055/s-0038-1675168
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author Ishi, Yukitomo
Terasaka, Shunsuke
Motegi, Hiroaki
author_facet Ishi, Yukitomo
Terasaka, Shunsuke
Motegi, Hiroaki
author_sort Ishi, Yukitomo
collection PubMed
description Background  Anterior transpetrosal approach and the combined transpetrosal approach are the major surgical approaches for petroclival meningiomas. However, anterior petrosectomy is not preferable in cases with postoperative venous drainage disorder of the sylvian vein due to anatomical variations. Here we present a case of the successful removal of petroclival meningioma by the retrosigmoid intradural suprameatal approach (RISA). Case Presentation  The patient was a 59-year-old woman with incidentally detected right petroclival meningioma. Although she had no neurological deficit, the tumor manifested with gradual growth on annual magnetic resonance imaging (MRI) during an 8-year follow-up. Three-dimensional computed tomography venography (3D–CTV) revealed sphenobasal type of the sylvian vein throughout the lateral side of the foramen ovale. Because the suprameatal tubercle was an obstacle to observe the Meckel's cave, RISA was selected for complete tumor excision. RISA could provide an excellent operative field around the Meckel's cave to confirm the remnant tumor. Postoperative MRI showed no evidence of the tumor, and the patient was discharged without any neurological deficit. Conclusion  RISA can provide a favorable operative field for petroclival meningioma, particularly for cases with high risk of postoperative complications related to the sylvian vein. The link to the video can be found at: https://youtu.be/cfci_zk0StU .
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spelling pubmed-65346982020-06-01 Retrosigmoid Intradural Suprameatal Approach for Petroclival Meningioma Ishi, Yukitomo Terasaka, Shunsuke Motegi, Hiroaki J Neurol Surg B Skull Base Background  Anterior transpetrosal approach and the combined transpetrosal approach are the major surgical approaches for petroclival meningiomas. However, anterior petrosectomy is not preferable in cases with postoperative venous drainage disorder of the sylvian vein due to anatomical variations. Here we present a case of the successful removal of petroclival meningioma by the retrosigmoid intradural suprameatal approach (RISA). Case Presentation  The patient was a 59-year-old woman with incidentally detected right petroclival meningioma. Although she had no neurological deficit, the tumor manifested with gradual growth on annual magnetic resonance imaging (MRI) during an 8-year follow-up. Three-dimensional computed tomography venography (3D–CTV) revealed sphenobasal type of the sylvian vein throughout the lateral side of the foramen ovale. Because the suprameatal tubercle was an obstacle to observe the Meckel's cave, RISA was selected for complete tumor excision. RISA could provide an excellent operative field around the Meckel's cave to confirm the remnant tumor. Postoperative MRI showed no evidence of the tumor, and the patient was discharged without any neurological deficit. Conclusion  RISA can provide a favorable operative field for petroclival meningioma, particularly for cases with high risk of postoperative complications related to the sylvian vein. The link to the video can be found at: https://youtu.be/cfci_zk0StU . Georg Thieme Verlag KG 2019-06 2018-11-01 /pmc/articles/PMC6534698/ /pubmed/31143599 http://dx.doi.org/10.1055/s-0038-1675168 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Ishi, Yukitomo
Terasaka, Shunsuke
Motegi, Hiroaki
Retrosigmoid Intradural Suprameatal Approach for Petroclival Meningioma
title Retrosigmoid Intradural Suprameatal Approach for Petroclival Meningioma
title_full Retrosigmoid Intradural Suprameatal Approach for Petroclival Meningioma
title_fullStr Retrosigmoid Intradural Suprameatal Approach for Petroclival Meningioma
title_full_unstemmed Retrosigmoid Intradural Suprameatal Approach for Petroclival Meningioma
title_short Retrosigmoid Intradural Suprameatal Approach for Petroclival Meningioma
title_sort retrosigmoid intradural suprameatal approach for petroclival meningioma
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534698/
https://www.ncbi.nlm.nih.gov/pubmed/31143599
http://dx.doi.org/10.1055/s-0038-1675168
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