caa a22 4500 445329424 CHVBK 20180317142732.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s10143-010-0299-9 doi (NATIONALLICENCE)springer-10.1007/s10143-010-0299-9 Two step approach for surgical removal of petroclival meningiomas with large supratentorial extension [Elektronische Daten] [Madjid Samii, Venelin Gerganov, Mario Giordano, Amir Samii] The treatment of petroclival meningiomas is still a matter of controversy in literature. In the last decades, many approaches have been introduced. Our strategy for the treatment of such tumors having large supratentorial extension with encasement of the internal carotid artery or compression of optic and oculomotor nerves has evolved in the attempt to improve the outcome. Currently, we favor a surgical technique consisting of two steps. As first step, we perform a retrosigmoid suprameatal approach in order to resect the posterior part of the tumor and obtain brainstem decompression. In the second step, carried out after patient's recovery from the first surgery, we remove the supratentorial portion of the lesion using a frontotemporal craniotomy to achieve the decompression of the optic nerve, oculomotor nerve, and carotid artery. The retrosigmoid suprameatal approach allows for adequate brainstem decompression: the tumor itself creates a surgical channel increasing the accessibility to the lower and upper petroclival surface. Moreover, this route allows for early visualization of cranial nerves in the posterior fossa and safe tumor removal under direct visual control, reducing the risk of postoperative deficits. Via the simple and safe frontotemporal craniotomy, the supratentorial part of the lesion can be removed thus avoiding the need of invasive approaches. We propose a two-stage surgery for treatment of petroclival meningiomas combining two simple routes such as retrosigmoid suprameatal and frontotemporal craniotomy. This approach reflects our philosophy to use simple and less invasive approaches in order to preserve neurological function and a good quality of life of the patient. Springer-Verlag, 2010 Petroclival meningiomas nationallicence Retrosigmoid suprameatal approach nationallicence Frontotemporal approach nationallicence Samii Madjid Department of Neurosurgery, International Neuroscience Institute, Rudolf-Pichlmayer-Straße. 4, 30625, Hannover, Germany aut Gerganov Venelin Department of Neurosurgery, International Neuroscience Institute, Rudolf-Pichlmayer-Straße. 4, 30625, Hannover, Germany aut Giordano Mario Department of Neurosurgery, International Neuroscience Institute, Rudolf-Pichlmayer-Straße. 4, 30625, Hannover, Germany aut Samii Amir Department of Neurosurgery, International Neuroscience Institute, Rudolf-Pichlmayer-Straße. 4, 30625, Hannover, Germany aut Neurosurgical Review Springer-Verlag 34/2(2011-04-01), 173-179 0344-5607 34:2<173 2011 34 10143 https://doi.org/10.1007/s10143-010-0299-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10143-010-0299-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Samii Madjid Department of Neurosurgery, International Neuroscience Institute, Rudolf-Pichlmayer-Straße. 4, 30625, Hannover, Germany aut NATIONALLICENCE 700 1- Gerganov Venelin Department of Neurosurgery, International Neuroscience Institute, Rudolf-Pichlmayer-Straße. 4, 30625, Hannover, Germany aut NATIONALLICENCE 700 1- Giordano Mario Department of Neurosurgery, International Neuroscience Institute, Rudolf-Pichlmayer-Straße. 4, 30625, Hannover, Germany aut NATIONALLICENCE 700 1- Samii Amir Department of Neurosurgery, International Neuroscience Institute, Rudolf-Pichlmayer-Straße. 4, 30625, Hannover, Germany aut NATIONALLICENCE 773 0- Neurosurgical Review Springer-Verlag 34/2(2011-04-01), 173-179 0344-5607 34:2<173 2011 34 10143 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer