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Published: 2026-01-28
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DOI: https://doi.org/10.52852/tcncyh.v198i1.4518
Issue
Vol. 198 No. 1 (2026)
Section
Các bài báo
How to Cite
Duy, P., Tùng, T. S., Hùng, N. M., & Đông, N. Đức. (2026). Combined petrosal approach for petroclival meningioma: Surgical technique and early outcomes. Journal of Medical Research, 198(1), 412-419. https://doi.org/10.52852/tcncyh.v198i1.4518

Combined petrosal approach for petroclival meningioma: Surgical technique and early outcomes

Pham Duy, Tran Son Tung, Ngo Manh Hung, Nguyen Duc Dong

Main Article Content

Abstract

Petroclival meningiomas are challenging due to deep location and neurovascular involvement. The combined petrosal approach provides wide access to both middle and posterior fossae. We describe key surgical steps and report early outcomes. This descriptive study included 6 patients with petroclival meningiomas who underwent surgery from October 2024 to June 2025, comprising 5 females and 1 male, with an average age of 55 years old (ranging from 40 to 71). Mean tumor diameter was 50 millimeters, mostly upper clival. Mean operative time was 336 minutes, range from 140 to 660. Gross total resection achieved in 50 percent, near total or subtotal resection in 50 percent. New deficits occurred in 33 percent with one facial numbness and one abducens palsy, both recovered. There was no mortality or severe complication, and no cerebrospinal fluid leak.The combined petrosal approach is feasible and safe for large tumors, enabling maximal safe resection with acceptable complication rates. Larger studies with long term follow up are warranted.

Article Details

Keywords

Petroclival meningioma, combined petrosal approach, skull base surgery

References

1. Dolenc VV, Rogers L. Microsurgical Anatomy and Surgery of the Central Skull Base. Springer; 2003.
2. Fava A, Di Russo P, Passeri T, et al. The mini-combined transpetrosal approach: an anatomical study and comparison with the combined transpetrosal approach. Acta Neurochir (Wien). 2022; 164(4): 1079-1093. doi:10.1007/s00701-022-05124-x.
3. Isolan GR, Wayhs SY, Lepski GA, Dini LI, Lavinsky J. Petroclival Meningiomas: Factors Determining the Choice of Approach. J Neurol Surg Part B Skull Base. 2018; 79(4): 367-378. doi:10.1055/s-0037-1608654.
4. Almefty R, Dunn IF, Pravdenkova S, Abolfotoh M, Al-Mefty O. True petroclival meningiomas: results of surgical management: Clinical article. J Neurosurg. 2014; 120(1): 40-51. doi:10.3171/2013.8.JNS13535.
5. Roche PH, Fournier HD, Sameshima T, Fukushima T. La pétrectomie combinée: Bases anatomiques, technique chirurgicale et indications. Neurochirurgie. 2008; 54(1): 1-10. doi:10.1016/j.neuchi.2007.08.006.
6. Al-Mefty O, Fox JL, Smith RR. Petrosal approach for petroclival meningiomas. Neurosurgery. 1988; 22(3): 510-517. doi:10.1227/00006123-198803000-00010.
7. Hưởng NĐ, Hùng NM, Quân TH. Ứng dụng đường mổ cắt bán phần trước xương đá điều trị u màng não xương đá - dốc nền. Published online 2024.
8. Phong N, Hải ĐH. Vi phẫu thuật u màng não mặt sau xương đá qua đường mổ sau xoang xích ma. Published online 2015.
9. Hanakita S, Watanabe K, Champagne PO, Froelich S. How I do it: combined petrosectomy. Acta Neurochir (Wien). 2019; 161(11): 2343-2347. doi:10.1007/s00701-019-04022-z.
10. Cho CW, Al-Mefty O. Combined petrosal approach to petroclival meningiomas. Neurosurgery. 2002; 51(3): 708-716; discussion 716-718.
11. Hakuba A, Nishimura S, Jang BJ. A combined retroauricular and preauricular transpetrosal-transtentorial approach to clivus meningiomas. Surg Neurol. 1988; 30(2): 108-116. doi:10.1016/0090-3019(88)90095-x.
12. Xu F, Karampelas I, Megerian CA, Selman WR, Bambakidis NC. Petroclival meningiomas: an update on surgical approaches, decision making, and treatment results. Neurosurg Focus. 2013; 35(6): E11. doi:10.3171/2013.9.FOCUS13319.
13. Haq IBI, Susilo RI, Goto T, Ohata K. Dural incision in the petrosal approach with preservation of the superior petrosal vein. J Neurosurg. 2016; 124(4): 1074-1078. doi:10.3171/2015.3.JNS141618.
14. Byun J, Roh H, Jo H, et al. Comparison of the efficacy in improving trigeminal neuralgia in petroclival meningioma between microsurgery and radiosurgery: a meta-analysis. Neurosurg Rev. 2023; 46(1): 314. doi:10.1007/s10143-023-02225-8.
15. Horgan MA, Anderson GJ, Kellogg JX, et al. Classification and quantification of the petrosal approach to the petroclival region. Published online July 1, 2000. doi:10.3171/jns.2000.93.1.0108.
16. Sekhar LN, Schessel DA, Bucur SD, Raso JL, Wright DC. Partial Labyrinthectomy Petrous Apicectomy Approach to Neoplastic and Vascular Lesions of the Petroclival Area. Neurosurgery. 1999; 44(3): 537.
17. Joo W, Rhoton AL. Microsurgical anatomy of the trochlear nerve. Clin Anat N Y N. 2015; 28(7): 857-864. doi:10.1002/ca.22602.
18. Tubbs RS, Oakes WJ. Relationships of the cisternal segment of the trochlear nerve. J Neurosurg. 1998; 89(6): 1015-1019. doi:10.3171/jns.1998.89.6.1015.