Middle fossa transpetrosal-transtentorial approaches for XXXX . Selective pyramid resection and radicality.

@entity1 @entity129 @entity5 @entity4 @entity1653
Forty-two @entity1 with @entity1653 were operated upon by the middle fossa transpetrosal-transtentorial approaches since 1977. Half of those showed @entity5 extension into the middle fossa and one-third in the cavernous sinus. Seventeen (40%) had a large @entity5 of 40 mm in diameter or larger, and 8 of those had a broad attachment from the clivus to petrous pyramid of the temporal bone. The site of pyramid resection was selected from three types, depending on the @entity5 location and the @entity1 ' pre-operative hearing. There was no surgical mortality. Significant risk of lower @entity129 was minimal and useful hearing was preserved in 18 out of 21 @entity1 . The follow-up, an average of 4 and a half years, showed @entity5 were completely eradicated in 32 @entity1 (76%) and there was regrowth in 3 (7%). Thirty-four @entity1 (81%) were independent, 3 disabled and only one died of rapid @entity5 regrowth. The most influential factor on surgical results was the extent to which the @entity5 had invaded the brain stem. The presence or absence of arterial encasement and of peritumoural @entity4 on MRI were important in the selection for radical surgery.
