SURGICAL OUTCOME OF POSTERIOR PETROUS BONE MENINGIOMAS
Meningiomas are very common brain tumors. When located in posterior cranial fossa, these tumors often cause compression and herniation of the brain stem, causing difficulties during resection and, sometimes, severe post-op complications. Last decade articles are aimed at the gross total resection, as well as functional outcome and quality of life. The aim of this study was to evaluate the results of surgical treatment for posterior petrous bone meningiomas (PPB). The study features 37 patients from the last 10 years who underwent surgery due to PPB. All patients were evaluated by clinical picture, neurological and functional status, Karnofsky performance scale (KPS) and neuroimaging pre- and post-op. Surgeries were accompanied with intraoperative neurophysiological monitoring. Gross total resection rates were evaluated with Simpson scale (1957). Morphology and grade of resected tumors were evaluated according to WHO classification (2007). All patients underwent one-step surgery. Maximum gross total resection grade was achieved in 94% of the cases. Histology demonstrated mostly benign tumors (97% were Grade I-II). Post-op complications were observed in 35% (13 patients). Two weeks after treatment, these complications have disappeared completely or partially in 10% of the patients. Surgeries caused the quality of life to deteriorate, with KPS decreasing to the average of 65, returning to near-preop of 80 in two weeks. There was no post-op mortality. Thus, we concluded that efficient neuroimaging, microneurosurgical resection techniques with operating microscope, intraoperative neurophysiological monitoring and adequate patient positioning provide the required conditions for good post-op outcome with low complication rates, comparable to literature data.