PlumX Metrics
Embed PlumX Metrics

Postoperative Complications and Neurological Deficits after Petroclival Region Meningioma Resection: A Case Series

Operative Neurosurgery, ISSN: 2332-4260, Vol: 25, Issue: 3, Page: 251-259
2023
  • 4
    Citations
  • 0
    Usage
  • 8
    Captures
  • 0
    Mentions
  • 0
    Social Media
Metric Options:   Counts1 Year3 Year

Metrics Details

Article Description

BACKGROUND:Surgical management of meningiomas involving the petroclival junction remains a challenge because of nearby critical neurovascular structures.OBJECTIVE:To describe surgical approach selection, outcomes, and factors associated with postoperative complications and neurological deficits in a series of patients undergoing resection of petroclival region meningiomas.METHODS:Retrospective review of patients undergoing symptomatic petroclival region meningioma resection was performed. Logistic regression was performed to identify variables associated with postoperative complications and new neurological deficits.RESULTS:Sixty-five patients underwent 54 one-stage and 11 two-stage resections with median follow-up of 51 months. Most tumors were World Health Organization grade 1 (90.8%), and the median volume was 23.9 cm3. Posterior petrosectomy and anterior petrosectomy were performed in 67.1% and 6.6% of operations, respectively. The gross or near total resection rate was 15.4%, and 8 patients (12.3%) progressed on follow-up. The surgical complication rate was 26.2% with no perioperative mortalities. Postoperatively, 45.8% of patients had new, persistent neurological deficits, with cranial nerves VII palsy being most common. On multivariate analysis, higher body mass index (odds ratio [OR]: 1.1, P =. 04) was associated with risk of surgical complications. Longer operative time (OR: 1.4, P =. 004) and staged procedures (OR: 4.9, P =. 04) were associated with risk of new neurological deficit on follow-up, likely reflecting more challenging tumors. Comparing early vs later career surgeries performed by the senior author, rates of severe complications and neurological deficits decreased 23.1% and 22.3%, respectively.CONCLUSION:Petroclival region meningiomas remain surgically challenging, but improved outcomes are seen with surgeon experience. These data help inform patients on perioperative morbidity risk and provide a guide for surgical approach selection.

Bibliographic Details

Minh P. Nguyen; Ramin A. Morshed; Philip V. Theodosopoulos; Steven W. Cheung; Michael W. McDermott

Ovid Technologies (Wolters Kluwer Health)

Medicine

Provide Feedback

Have ideas for a new metric? Would you like to see something else here?Let us know