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Factors Associated With Abducens Nerve Palsy in Patients Undergoing Surgery for Petroclival Meningiomas

 Jihwan Yoo  ;  Seung Hun Lim  ;  In-Ho Jung  ;  Hun Ho Park  ;  Jinu Han  ;  Chang-Ki Hong 
 JOURNAL OF NEURO-OPHTHALMOLOGY, Vol.42(1) : e209-e216, 2022-03 
Journal Title
Issue Date
Abducens Nerve Diseases* / diagnosis ; Abducens Nerve Diseases* / etiology ; Abducens Nerve Diseases* / surgery ; Atrial Natriuretic Factor ; Humans ; Meningeal Neoplasms* / complications ; Meningeal Neoplasms* / surgery ; Meningioma* / complications ; Meningioma* / surgery ; Neurosurgical Procedures / adverse effects ; Neurosurgical Procedures / methods ; Retrospective Studies ; Skull Base Neoplasms* / complications ; Treatment Outcome
Background: During the surgical resection of petroclival meningiomas, preserving the cranial nerves is crucial. The abducens nerve is particularly vulnerable during surgery. However, the preoperative risk factors and postoperative prognosis of abducens nerve palsy (ANP) are poorly understood.

Methods: We retrospectively analyzed 70 patients who underwent surgery for petroclival meningiomas between May 2010 and December 2019, divided into gross-total resection (GTR) and subtotal resection (STR) groups. The relationship of preoperative clinical factors with the incidence and recovery of postoperative ANP was analyzed.

Results: Postoperative ANP was observed in 23 patients (32.9%). Multivariable logistic regression revealed that the tumor-to-cerebellar peduncle T2 imaging intensity index (TCTI) (P < 0.001) and internal auditory canal invasion (P = 0.033) contributed to postoperative ANP. GTR was achieved in 37 patients (52.9%), and 10 (27.0%) of them showed ANP. STR was achieved in 33 patients (47.1%), and 13 (39.4%) of them showed ANP. Recovery from ANP took a median of 6.6 months (range, 4.5-20.3 months). At 6 months after the operation, recovery of the abducens nerve function was observed in 16 patients (69.0%); of whom, 4 (40.0%) were in the GTR group and 12 (92.3%) were in the STR group (P = 0.025).

Conclusions: TCTI and internal auditory canal invasion were the risk factors for postoperative ANP. Although intentional STR did not prevent ANP immediately after the operation, recovery of the abducens nerve function after surgery was observed more frequently in the STR group than in the GTR group.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Park, Hun Ho(박현호) ORCID logo https://orcid.org/0000-0002-2526-9693
Yoo, Jihwan(유지환)
Jung, In-Ho(정인호)
Han, Jinu(한진우) ORCID logo https://orcid.org/0000-0002-8607-6625
Hong, Chang Ki(홍창기) ORCID logo https://orcid.org/0000-0002-2761-0373
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