Posterior petrous face meningiomas

OBJECTIVE: To define the clinical presentation, treatment options, and outc omes for a subset of meningiomas of the posterior fossa skull base that ari se from the posterior petrous face between the region of the porus acoustic us and the sigmoid sinus. STUDY DESIGN AND SETTING: A retrospective chart review from a large skull b ase surgery practice at a tertiary care institution. RESULTS: This cohort of patients presented with minimal symptoms, yet large tumors, averaging 3.8 ems and causing significant cerebellar compression. Retrosigmoid craniotomies afforded excellent exposure. CONCLUSION AND SIGNIFICANCE: Patients with large tumors emanating from the posterior fossa aspect of the temporal bone should be evaluated on the basi s of their site of origin. Patients with tumors emanating from the anterior or ventral portion of the temporal bone have greater symptoms and greater operative complications than those emanating from the posterior petrous fac e, between the porus acousticus and sigmoid sinus.