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Petrous bone lesions: surgical implementation and outcomes of extradural subtemporal approach.

Publication ,  Journal Article
Bawornvaraporn, U; Zomorodi, AR; Friedman, AH; Fukushima, T
Published in: Acta Neurochir (Wien)
October 2021

BACKGROUND: Petrous bone lesions (PBLs) are rare with few reports in the neurosurgical literature. In this study, the authors describe our current technique of extradural subtemporal approach (ESTA). The objective of this study was to evaluate the role and efficacy of ESTA for treatment of the PBLs. To our knowledge, this is the largest reported clinical series of using an ESTA-treated PBLs in which the clinical outcomes were evaluated. METHODS: Between 1994 and 2019, 67 patients with PBLs treated by ESTA were retrospectively reviewed. Extent of resection, neurological outcomes, recurrence rate, and surgical complications were evaluated and compared with previous studies. The indications, advantages, limitations, and outcomes of ESTA were analyzed according to pathology. RESULTS: This series included 7 facial nerve schwannomas (10.4%), 16 cholesterol granulomas (23.9%), 16 chordomas (23.9%), 6 chondrosarcomas (9%), 5 trigeminal schwannomas (7.5%), 9 epidermoids/dermoids (13.4%), and 8 other pathologies (11.9%). The most common location of PBLs operated with ESTA was at the petrous apex and rhomboid areas (68.7%). Gross total resection was achieved in 35 (55.6%). Symptomatic improvement occurred in 56 patients (83.6%). Complications occurred in 7 (10.4%) of cases including one mortality. Nine patients (17%) had recurrence within the mean follow-up 71 months. Compared to previous literature, our results demonstrated comparable outcomes but with higher rates of hearing and facial nerve preservation as well as minimal morbidity. From our results, ESTA is an effective therapeutic option for lesions located at the rhomboid and petrous apex, particularly when patients presented with intact facial and hearing function. CONCLUSION: Our series demonstrated that ESTA provided satisfactory outcomes with excellent benefits of hearing and facial function preservation for patients with petrous bone lesions. ESTA should be considered as a safe and effective therapeutic option for selected patients with PBLs.

Duke Scholars

Published In

Acta Neurochir (Wien)

DOI

EISSN

0942-0940

Publication Date

October 2021

Volume

163

Issue

10

Start / End Page

2881 / 2894

Location

Austria

Related Subject Headings

  • Retrospective Studies
  • Petrous Bone
  • Neurology & Neurosurgery
  • Humans
  • Granuloma
  • Cholesterol
  • Bone Neoplasms
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences
 

Citation

APA
Chicago
ICMJE
MLA
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Bawornvaraporn, U., Zomorodi, A. R., Friedman, A. H., & Fukushima, T. (2021). Petrous bone lesions: surgical implementation and outcomes of extradural subtemporal approach. Acta Neurochir (Wien), 163(10), 2881–2894. https://doi.org/10.1007/s00701-021-04962-5
Bawornvaraporn, Udom, Ali R. Zomorodi, Allan H. Friedman, and Takanori Fukushima. “Petrous bone lesions: surgical implementation and outcomes of extradural subtemporal approach.Acta Neurochir (Wien) 163, no. 10 (October 2021): 2881–94. https://doi.org/10.1007/s00701-021-04962-5.
Bawornvaraporn U, Zomorodi AR, Friedman AH, Fukushima T. Petrous bone lesions: surgical implementation and outcomes of extradural subtemporal approach. Acta Neurochir (Wien). 2021 Oct;163(10):2881–94.
Bawornvaraporn, Udom, et al. “Petrous bone lesions: surgical implementation and outcomes of extradural subtemporal approach.Acta Neurochir (Wien), vol. 163, no. 10, Oct. 2021, pp. 2881–94. Pubmed, doi:10.1007/s00701-021-04962-5.
Bawornvaraporn U, Zomorodi AR, Friedman AH, Fukushima T. Petrous bone lesions: surgical implementation and outcomes of extradural subtemporal approach. Acta Neurochir (Wien). 2021 Oct;163(10):2881–2894.
Journal cover image

Published In

Acta Neurochir (Wien)

DOI

EISSN

0942-0940

Publication Date

October 2021

Volume

163

Issue

10

Start / End Page

2881 / 2894

Location

Austria

Related Subject Headings

  • Retrospective Studies
  • Petrous Bone
  • Neurology & Neurosurgery
  • Humans
  • Granuloma
  • Cholesterol
  • Bone Neoplasms
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences