MIDDLE FOSSA TRANSPETROSAL APPROACH FOR PETROCLIVAL AND BRAIN-STEM TUMORS

Objective: The purpose of the study was to demonstrate the utility of the middle fossa transpetrosal approach with anterior petrosectomy for difficult-to-access petroclival and pontine lesions. Study Design: Re trospective case review in academic tertiary referral center. Methods: Patients for inclusion had pontine and prepontine lesions of the petr oclival region. Middle fossa transpetrosal approach with anterior petr osectomy with excision or biopsy of the lesion was performed. The main outcome measure was postoperative neurologic status including motor a nd cranial nerve function. Results: No patient experienced neuromuscul ar compromise or cranial nerve deficits as a direct result of the surg ical procedure. Complications consisted of a subdural temporal lobe he morrhage and one case of cerebrospinal fluid rhinorrhea, Conclusions T he middle fossa transpetrosal approach with anterior petrosectomy was utilized for five patients with petroclival or pontine tumors. In this small series, it served well to spare cranial nerves and allowed avoi dance of serious vascular injury. To our knowledge, this is the first reported use of this procedure for pontine venous angiomas.