The Strategy of Surgical Treatment on the Petroclival Tumors

Objective To investigate the strategies of surgical treatment on petroclival tumors.Methods The data of 49patients with petroclival tumors resected using three different surgical approaches including petrous bone presigmoid approach,temporal transtentorial approach,sigmoid sinus approach aided with neuroendoscopy and electrophysiological monitoring were analyzed retrospectively;the effect of surgery and postoperative complications were also recorded.Results There were 11cases using petrous bone presigmoid approach with complete tumor removal in 8patients.New neurological damages were observed in four cases,and 3cases showed improved neurological function after operation,while the symptoms did not improve in the rest 4cases.Tumors were completely resected in 12out of 18cases using temporal transtentorial approach.Within these 18cases,four got new neurological damages,two showed aggravated neurological damages,5had improved neurological function and the rest 7cases had the same symptom after operation.There were 20cases using sigmoid sinus approach with complete tumor removal in 18cases.The original neurological damages of 5cases aggravated.The neurological function of 8cases had been improved,while the rest 7cases had the same symptom after operation.All patients survived after operation.Conclusion There are three preferred basic approaches to manage the petroclival tumors,which include petrous bone presigmoid approach,temporal transtentorial approach and sigmoid sinus approach.Improving complete tumor resection rate and reducing the incidence of complications or mortality can be achieved by a combination with neuroendoscopy and electrophysiological monitoring.