Preservation of Venous Drainage in Middle Fossa During Combined Transpetrosal Approach for Petroclival Meningioma

Preservation of Venous Drainage in Middle Fossa During Combined Transpetrosal Approach for Petroclival Meningioma

Accepted Manuscript Preservation of venous drainage in middle fossa during combined transpetrosal approach for petroclival meningioma Ken Matsushima, ...

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Accepted Manuscript Preservation of venous drainage in middle fossa during combined transpetrosal approach for petroclival meningioma Ken Matsushima, M.D, Michihiro Kohno, M.D., Ph.D, Hitoshi Izawa, M.D, Yujiro Tanaka, M.D PII:

S1878-8750(18)32774-8

DOI:

https://doi.org/10.1016/j.wneu.2018.11.215

Reference:

WNEU 10899

To appear in:

World Neurosurgery

Received Date: 13 October 2018 Revised Date:

23 November 2018

Accepted Date: 26 November 2018

Please cite this article as: Matsushima K, Kohno M, Izawa H, Tanaka Y, Preservation of venous drainage in middle fossa during combined transpetrosal approach for petroclival meningioma, World Neurosurgery (2019), doi: https://doi.org/10.1016/j.wneu.2018.11.215. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

ACCEPTED MANUSCRIPT Matsushima

Preservation of venous drainage in middle fossa during combined transpetrosal approach for petroclival meningioma Ken Matsushima, M.D.a, Michihiro Kohno, M.D., Ph.D.a, Hitoshi Izawa, M.D.a, Yujiro

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Tanaka, M.D.a Department of Neurosurgery, Tokyo Medical University, #6-7-1 Nishishinjuku,

Shinjuku-ku, Tokyo 160-0023, Japan

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Corresponding author: Michihiro Kohno M.D., Ph.D.

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Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan #6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan E-mail: [email protected]

Fax: +81-3-3340-4285

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Phone: +81-3-3342-6111

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Keywords: Mastoidectomy; Pterygoid plexus; Skull base surgery; Sphenobasal vein; Sphenopetrosal vein; Superficial middle cerebral vein; Venous anatomy.

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Running Title: Epi- and subdural petrosectomy preserving middle fossa veins

Disclosure: The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.

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Preservation of venous drainage in middle fossa during combined transpetrosal approach for petroclival meningioma Abstract

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The combined transpetrosal approach enables wide exposure around the petroclival region by lifting of the middle fossa dura and cutting of the tentorium. However,

interruption of the venous drainage on the middle skull base during the transpetrosal

approach has been reported to lead to temporal lobe damage.(1,2) This video (Video 1)

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demonstrates a microsurgical technique for the preservation of various venous drainage in the middle fossa, including the sphenobasal and sphenopetrosal veins, during the

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combined transpetrosal approach for treatment of a petroclival meningioma. The patient is a 51-year-old woman with a petroclival meningioma extending into the cavernous sinus. The superficial middle cerebral vein drained into the foramen ovale as the sphenobasal vein, and the sphenopetrosal vein draining into the superior petrosal sinus coursed on the middle skull base. A developed middle meningeal vein was also identified on the middle skull base. While preserving the venous drainage in the middle fossa by a

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modified incision of the middle fossa dura, sufficient decompression of the brainstem was achieved by removal of the cisternal part of the tumor. The patient developed diplopia after the surgery, but her headache and dizziness were improved without other neurological deficits. The patient’s diplopia improved within 1 year after the surgery,

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without any other neurological deficits or tumor regrowth during the follow-up period of

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3 years. Informed consent was obtained from the patient.

References 1.

Ichimura S, Yoshida K, Kagami H, Inaba M, Orii M, Kitamura Y, Saga I, Toda M: Epidural anterior petrosectomy with subdural visualization of sphenobasal vein via the anterior transpetrosal approach--technical case report. Neurosurg Rev. 35:609-613, 2012

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Shibao S, Toda M, Orii M, Fujiwara H, Yoshida K: Various patterns of the middle cerebral vein and preservation of venous drainage during the anterior

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transpetrosal approach. J Neurosurg. 124:432-439, 2016.

Acknowledgements: We thank Ms. Asa Otonari and Ms. Kaori Noda for their assistance

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in preparing this video.

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Epidural anterior petrosectomy with subdural visualization of sphenobasal vein via the anterior transpetrosal approach—technical case report

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Preservation of venous drainage in middle fossa during combined transpetrosal approach for petroclival meningioma: Operative video

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World Neurosurgery

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ACCEPTED MANUSCRIPT Matsushima

Disclosure:

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October 13th, 2018 I, Dr. Michihiro Kohno, certify that this manuscript is a unique submission and is not

being considered for publication, in part or in full, with any other source in any medium. The authors have no personal or institutional financial interest in any of the materials or

Sincerely, Michihiro Kohno, M.D., Ph.D. Professor and Chairman, Department of Neurosurgery,

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Tokyo Medical University

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devices described in this publication.

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Abbreviations: N/A

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