This article presents the surgical results in a series of 16 petrocliv
al meningiomas operated on from 1984-1990. Tumors with marked infiltra
tion of the cavernous sinus, which belong to the category of spheno-pe
tro-clival meningiomas, were excluded. The 16 petroclival meningiomas
were all surgically treated using the combined transmastoid temporosub
occipital approach that offers a number of possible variants: retrosig
moidal, with or without recision of the sinus; presigmoidal retro-, or
translabyrinthine. The choice of one or another of these variants dep
ends on certain clinical (preoperative hearing status) and anatomic (s
ize and extension, central or lateral, of the tumor; patency of the tr
ansverse sinuses; size and position, more or less anterior, of the sig
moid sinus; position, more or less high, of the jugular bulb) factors.
The principle indications for each of these approaches are given with
particular emphasis on their relative advantages and limitations.