GROSS-TOTAL RESECTION RATE OF PETROCLIVAL MENINGIOMAS VIA THE ANTERIOR TRANSPETROSAL APPROACH
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Abstract
Objective: To determine the gross-total resection (GTR) rate on early postoperative contrast-enhanced magnetic resonance imaging (MRI) in patients with petroclival meningioma operated on through the anterior transpetrosal approach.
Subjects and methods: A consecutive descriptive case series combining retrospective and prospective data collection in 32 patients operated on at Viet Duc University Hospital between January 2020 and December 2025. GTR was defined as the absence of nodular or mass-like enhancing tissue at the preoperative tumour site on contrast-enhanced MRI obtained 24–72 hours after surgery. The proportion is reported with a 95% Wilson confidence interval (CI).
Results: Mean age was 53.5 ± 12.9 years; 78.1% were female. Mean maximal tumour diameter was 33.2 ± 14.2 mm; 40.6% invaded the cavernous sinus. GTR was achieved in 20/32 patients (62.5%; 95% CI: 45.3–77.1%); residual tumour was present in 12/32 (37.5%). By intraoperative Simpson grading, Simpson I–II was 53.1% and Simpson I–III was 68.8%. GTR was highest in the petrous apex subtype (9/11) and lowest in the cavernous sinus subtype (1/5).
Conclusion: In this selected series, the MRI-defined GTR rate was 62.5%, with a wide confidence interval reflecting the small sample. The estimate should be interpreted in the context of patient selection and a maximal safe resection policy.
Keywords
Petroclival meningioma, anterior transpetrosal approach, gross-total resection, postoperative MRI, skull base
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References
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