Combined petrosal approach for resection of petroclival meningioma
"Combined petrosal approach for resection of petroclival meningioma" Katsuyuki Asaoka, MD and Shunsuke Terasaka, MD Department of Neurosurgery, Teine Keijinkai Medical Center, and Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan The authors demonstrate a step-by-step surgical technique of the combined petrosal approach for resection of petroclival meningioma. The basic concept of this approach is the combination of the anterior- and posterior-petrosal approaches uniting the infra- and supra-tentorial surgical fields, thereby providing wide surgical exposure. Our techniques are featured by 1) mastoidectomy preceding craniotomy for minimal bone loss; 2) removal of the tentorium over the tumor for achieving devascularization and wide exposure; 3) water-tight dural closure by using autologous fascia graft, non-penetrating titanium clips, and multi-layered technique for avoiding postoperative cerebrospinal fluid leakage.
