title: Meningiomas of the upper and middle part of the clivus and surrounding structures: early and long-term outcome.
abstract: OBJECTIVE
  Meningiomas of the upper and middle parts of the clivus and surrounding structures are removed using petrosal approaches: anterior, posterior, combined and complete. The purpose of this study is to show the results of treatment of these meningiomas and to present our interpretation of the treatment strategy.
  
  
  METHODS
  Twenty-six patients (17 women, 9 men) were included in the study. The neurological status of the patients was assessed before and after surgery as well as at the conclusion of the treatment. The following measurements and data were collected and recorded: approximate volume of the treated lesion, its relation to large blood vessels, cranial nerves and the brainstem, as well as tumour consistency and vascularisation.
  
  
  RESULTS
  Symptoms duration ranged from 1 to 60 months (median: 16 months). In 57.7% of patients, imbalance was the predominant sign. Less frequent symptoms were: head-aches, dysacusis and hemiparesis. Approximate volumes of the tumours ranged from 4 to 65 mL (mean: 32 mL). Total or subtotal resection was achieved in 73.1% of patients. The patients' performance improved postoperatively in 34.5%, remained unchanged in 46.2% and deteriorated in 11.5% of patients. Two (7.8%) patients died after the surgery.
  
  
  CONCLUSIONS
  The use of petrosal approaches in the surgical treatment of meningiomas of the upper and middle parts of the clivus and the surrounding structures facilitates good or at least satisfactory neurological outcome with a high proportion of complete resections and relatively low mortality.
authors.affiliation: Katedra i Oddział Kliniczny Neurochirurgii, Śląski Uniwersytet Medyczny w Katowicach, Sosnowiec. sekr_nch@wss5.pl
authors.forename: P
authors.initials: P
authors.lastname: Ladziński
authors.forename: H
authors.initials: H
authors.lastname: Majchrzak
authors.forename: W
authors.initials: W
authors.lastname: Kaspera
authors.forename: M
authors.initials: M
authors.lastname: Maliszewski
authors.forename: K
authors.initials: K
authors.lastname: Majchrzak
authors.forename: M
authors.initials: M
authors.lastname: Tymowski
authors.forename: P
authors.initials: P
authors.lastname: Adamczyk
authors.forename: B
authors.initials: B
authors.lastname: Błaszczyk
authors.forename: A
authors.initials: A
authors.lastname: Slaska-Kaspera
mesh_terms: D000328:Adult; D000368:Aged; D003388:Cranial Fossa, Posterior; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011184:Postoperative Period; D016896:Treatment Outcome; D047368:Tumor Burden