岩斜坡脑膜瘤的早期手术结果：越南单中心病例系列

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management Pub Date : 2025-07-10 DOI:10.1016/j.inat.2025.102086

Huy Ngoc Pham , He Van Dong , Ha Dai Duong , Manh Huy Bui , Tuan Anh Le , Van Dinh Tran , Nguyen Cong Tien Anh

{"title":"岩斜坡脑膜瘤的早期手术结果：越南单中心病例系列","authors":"Huy Ngoc Pham , He Van Dong , Ha Dai Duong , Manh Huy Bui , Tuan Anh Le , Van Dinh Tran , Nguyen Cong Tien Anh","doi":"10.1016/j.inat.2025.102086","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>Petroclival meningiomas have been regarded as among the most difficult skull base lesions to operate. This study evaluated the early surgical outcome of petroclival meningiomas at one of the largest neurosurgery centers in Vietnam.</div></div><div><h3>Methods</h3><div>A series of 38 patients (28 females and 10 males) with petroclival meningiomas operated as the primary treatment from January 2021 to January 2023 were prospectively studied. Data was collected during patient hospitalization period and follow-ups at one month and six months after discharge.</div></div><div><h3>Results</h3><div>The mean preoperative Karnofsky Performance Scale (KPS) score was 75.53 and 26/38 (68.4 %) patients presented with cranial nerve deficits. The mean tumor equivalent diameter was 34.5 mm and 6 (15.8 %) cases demonstrated extensions into adjacent regions. Gross total resection (GTR) was achieved in 36.8 % of patients. Hyperintensity on MRI T2-weighted images was associated with a higher rate of GTR. 12/38 (31.6 %) patients had postoperative complications with 3 (7.9 %) hospital mortalities. Complications included 2 (5.3 %) intracranial hemorrhage, 1 (2.6 %) brainstem infarction, 1 (2.6 %) diffuse brain edema, 1 (2.6 %) newly developed hydrocephalus, 2 (5.3 %) cerebrospinal fluid leak, 2 (5.3 %) meningitis, 1 (2.6 %) surgical site infection, 3 (7.9 %) pneumonia and 6 (15.8 %) underwent tracheotomy. Headache, dizziness, limb weakness, ataxia, sensory disturbance, and sphincter dysfunction showed remarkable improvement, whereas CN dysfunction exhibited varying pattern of progression. 14/35 (40 %) patients developed new or exacerbation of preoperative neuropathies which mainly involved cranial nerves VI (14.3 %), VII (22.9 %), and VIII (14.3 %). The mean KPS score decreased to 69.21 at the 1-month follow-up and then improved to 74.47 six months after surgery. Follow-up MRI demonstrated one case with tumor recurrence after total resection and another case with lesion progression following subtotal resection.</div></div><div><h3>Conclusions</h3><div>Petroclival meningiomas remain as surgically challenging lesions. Despite limited resectability, surgery offers early favorable results. Hyperintensity on MRI T2-weighted image facilitates gross total resection.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102086"},"PeriodicalIF":0.5000,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Early surgical outcome of petroclival meningiomas: a single-center case series from Vietnam\",\"authors\":\"Huy Ngoc Pham , He Van Dong , Ha Dai Duong , Manh Huy Bui , Tuan Anh Le , Van Dinh Tran , Nguyen Cong Tien Anh\",\"doi\":\"10.1016/j.inat.2025.102086\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>Petroclival meningiomas have been regarded as among the most difficult skull base lesions to operate. This study evaluated the early surgical outcome of petroclival meningiomas at one of the largest neurosurgery centers in Vietnam.</div></div><div><h3>Methods</h3><div>A series of 38 patients (28 females and 10 males) with petroclival meningiomas operated as the primary treatment from January 2021 to January 2023 were prospectively studied. Data was collected during patient hospitalization period and follow-ups at one month and six months after discharge.</div></div><div><h3>Results</h3><div>The mean preoperative Karnofsky Performance Scale (KPS) score was 75.53 and 26/38 (68.4 %) patients presented with cranial nerve deficits. The mean tumor equivalent diameter was 34.5 mm and 6 (15.8 %) cases demonstrated extensions into adjacent regions. Gross total resection (GTR) was achieved in 36.8 % of patients. Hyperintensity on MRI T2-weighted images was associated with a higher rate of GTR. 12/38 (31.6 %) patients had postoperative complications with 3 (7.9 %) hospital mortalities. Complications included 2 (5.3 %) intracranial hemorrhage, 1 (2.6 %) brainstem infarction, 1 (2.6 %) diffuse brain edema, 1 (2.6 %) newly developed hydrocephalus, 2 (5.3 %) cerebrospinal fluid leak, 2 (5.3 %) meningitis, 1 (2.6 %) surgical site infection, 3 (7.9 %) pneumonia and 6 (15.8 %) underwent tracheotomy. Headache, dizziness, limb weakness, ataxia, sensory disturbance, and sphincter dysfunction showed remarkable improvement, whereas CN dysfunction exhibited varying pattern of progression. 14/35 (40 %) patients developed new or exacerbation of preoperative neuropathies which mainly involved cranial nerves VI (14.3 %), VII (22.9 %), and VIII (14.3 %). The mean KPS score decreased to 69.21 at the 1-month follow-up and then improved to 74.47 six months after surgery. Follow-up MRI demonstrated one case with tumor recurrence after total resection and another case with lesion progression following subtotal resection.</div></div><div><h3>Conclusions</h3><div>Petroclival meningiomas remain as surgically challenging lesions. Despite limited resectability, surgery offers early favorable results. Hyperintensity on MRI T2-weighted image facilitates gross total resection.</div></div>\",\"PeriodicalId\":38138,\"journal\":{\"name\":\"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management\",\"volume\":\"41 \",\"pages\":\"Article 102086\"},\"PeriodicalIF\":0.5000,\"publicationDate\":\"2025-07-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2214751925000982\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214751925000982","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目的岩斜坡脑膜瘤被认为是颅底手术中最困难的病变之一。本研究评估了越南最大的神经外科中心之一岩斜坡脑膜瘤的早期手术结果。方法对2021年1月至2023年1月行岩斜坡脑膜瘤为主治疗的38例患者（女28例，男10例）进行前瞻性研究。数据收集于患者住院期间，出院后1个月和6个月随访。结果术前KPS评分平均为75.53分，有26/38（68.4%）患者出现颅神经缺损。平均肿瘤当量直径为34.5 mm，有6例（15.8%）肿瘤扩展至邻近区域。总切除（GTR）率为36.8%。MRI t2加权图像上的高强度与较高的GTR率相关。12/38（31.6%）患者出现术后并发症，3（7.9%）患者住院死亡。并发症包括颅内出血2例（5.3%），脑干梗死1例（2.6%），弥漫性脑水肿1例（2.6%），新发脑积水1例（2.6%），脑脊液漏2例（5.3%），脑膜炎2例（5.3%），手术部位感染1例（2.6%），肺炎3例（7.9%），气管切开术6例（15.8%）。头痛、头晕、肢体无力、共济失调、感觉障碍和括约肌功能障碍均有显著改善，而CN功能障碍表现出不同的进展模式。14/35（40%）患者术前出现新的或加重的神经病变，主要累及脑神经VI（14.3%）、VII（22.9%）和VIII（14.3%）。术后1个月KPS平均评分为69.21，术后6个月KPS平均评分为74.47。随访MRI显示1例全切除后肿瘤复发，另1例次全切除后病变进展。结论斜坡脑膜瘤仍是具有手术挑战性的病变。尽管可切除性有限，但手术提供了早期良好的结果。MRI t2加权图像上的高强度有利于大体全切除。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Early surgical outcome of petroclival meningiomas: a single-center case series from Vietnam

Objective

Petroclival meningiomas have been regarded as among the most difficult skull base lesions to operate. This study evaluated the early surgical outcome of petroclival meningiomas at one of the largest neurosurgery centers in Vietnam.

Methods

A series of 38 patients (28 females and 10 males) with petroclival meningiomas operated as the primary treatment from January 2021 to January 2023 were prospectively studied. Data was collected during patient hospitalization period and follow-ups at one month and six months after discharge.

Results

The mean preoperative Karnofsky Performance Scale (KPS) score was 75.53 and 26/38 (68.4 %) patients presented with cranial nerve deficits. The mean tumor equivalent diameter was 34.5 mm and 6 (15.8 %) cases demonstrated extensions into adjacent regions. Gross total resection (GTR) was achieved in 36.8 % of patients. Hyperintensity on MRI T2-weighted images was associated with a higher rate of GTR. 12/38 (31.6 %) patients had postoperative complications with 3 (7.9 %) hospital mortalities. Complications included 2 (5.3 %) intracranial hemorrhage, 1 (2.6 %) brainstem infarction, 1 (2.6 %) diffuse brain edema, 1 (2.6 %) newly developed hydrocephalus, 2 (5.3 %) cerebrospinal fluid leak, 2 (5.3 %) meningitis, 1 (2.6 %) surgical site infection, 3 (7.9 %) pneumonia and 6 (15.8 %) underwent tracheotomy. Headache, dizziness, limb weakness, ataxia, sensory disturbance, and sphincter dysfunction showed remarkable improvement, whereas CN dysfunction exhibited varying pattern of progression. 14/35 (40 %) patients developed new or exacerbation of preoperative neuropathies which mainly involved cranial nerves VI (14.3 %), VII (22.9 %), and VIII (14.3 %). The mean KPS score decreased to 69.21 at the 1-month follow-up and then improved to 74.47 six months after surgery. Follow-up MRI demonstrated one case with tumor recurrence after total resection and another case with lesion progression following subtotal resection.

Conclusions

Petroclival meningiomas remain as surgically challenging lesions. Despite limited resectability, surgery offers early favorable results. Hyperintensity on MRI T2-weighted image facilitates gross total resection.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊