Background A lot of important structures located in or beside the petrous bone. When the lesions
invaded the petrous bone, the gross total resection of them would be difficult and
a challenge to neurosurgeon, especially if the lesions are huge.
Objective For achieving the gross total resection of the huge petrous bone-invasive tumors
and minimal damage to the important structures in the petrous bone, we combined several
different approaches to every individual patient. We also aimed to describe the technical
nuances and tips of the individual-designed approaches and microsurgery.
Methods Fifty-seven patients, who have huge petrous bone-invasive tumors (average diameter
is ∼5 cm), were admitted to our department between 2014 and 2016. All of them underwent
individualized microsurgery for resection of the lesions. According to the relationship
between the tumor and petrous bone, several different approaches were combined or
improved. We designed different approach and microsurgery for every individual patient.
Result The gross total resection was achieved in 52 cases, subtotal resection in 3 cases,
and partial resection in 2 cases. Fifty patients did not have new neurological dysfunction.
In the other seven patients who had new neurological dysfunction, four patients got
better after 3 to 6 months. The preoperative neurological dysfunction in 29 patients
was improved after the surgery. The most common complication was leakage of CSF. five
patients had this complication. There were no deaths in this study.
Conclusion The individual-designed approaches and microsurgery can increase the gross total
resection rate of the tumors and nerve protection rate. As a result, the outcome of
the patients who have the huge petrous bone-invasive tumors was improved significantly.
