OBJECTIVE: To define the clinical presentation, treatment options, and outcomes for a subset of meningiomas of the posterior fossa skull base that arise from the posterior petrous face between the region of the porus acousticus and the sigmoid sinus. STUDY DESIGN AND SETTING: A retrospective chart review from a large skull base surgery practice at a tertiary care institution. RESULTS: This cohort of patients presented with minimal symptoms, yet large tumors, averaging 3.8 cms and causing significant cerebellar compression. Retrosigmoid craniotomies afforded excellent exposure. CONCLUSION AND SIGNIFICANCE: Patients with large tumors emanating from the posterior fossa aspect of the temporal bone should be evaluated on the basis of their site of origin. Patients with tumors emanating from the anterior or ventral portion of the temporal bone have greater symptoms and greater operative complications than those emanating from the posterior petrous face, between the porus acousticus and sigmoid sinus.
