Retractorless Surgery for Petroclival Meningiomas via the Subtemporal Approach: A Try to Reduce Brain Retraction Injury

Abstract

Purpose. To present our experience with retractorless surgery for resection of petroclival meningiomas (PCMs) via the subtemporal approach with routine operative instruments. Methods. Clinical data of patients with PCMs who received surgical treatments via subtemporal approach were retrospectively analyzed. Patient demographics, duration of operation, extent of resection, postoperative brain injury rate, postoperative complication, and surgical outcome were reviewed. Results. Twenty-nine consecutive patients with retractorless surgery via subtemporal approach performed between November 2018 and November 2021. The gross total resection rate was 82.8% ( N = 24 ). The incidence of postoperative temporal lobe injury was 3.4% ( N = 1 ). All the procedures were completed without fixed retraction or other specialized instruments. Conclusions. Retractorless surgery via subtemporal approach is a reliable treatment option for PCMs, which can be completed with routine operative instruments.

Hemorrhagic schwannoma of the trochlear nerve: Case report and a review of the literature

“…In our patient, the classical subtemporal approach was used as in most prior cases. With this approach, adequate brain relaxation was achieved via spinal cerebrospinal fluid drainage, and then the temporal lobe was elevated after the division of several draining veins on the inferior surface of the brain tissue (55). The tumor was able to be completely excised with the protection of the surrounding vital structures via this approach.…”