{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:21:11Z","timestamp":1790662871162,"version":"4.1.0"},"reference-count":28,"publisher":"Media Sphere Publishing House","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Burdenko's Journal of Neurosurgery"],"published-print":{"date-parts":[[2023,8,31]]},"abstract":"<jats:p>Treatment of clival meningiomas is still one of the unresolved issues in modern neurosurgery. There are several treatment strategies. These ones include various combinations of follow-up, surgical CSF drainage, tumor resection and radiotherapy. Objective. To assess postoperative outcomes in patients with clival meningiomas. Material and methods. We analyzed 18 patients with large or giant clival meningiomas. Results. We assessed extent of resection using the scale by G. Frank and E. Pasquini (2002): total resection \u2014 95\u2014100%, subtotal \u2014 80\u201495%, partial \u2014 50\u201480%, extended biopsy \u2014 &lt;50% of tumor. Total resection was achieved in 1 patient (5.5%), subtotal \u2014 5 (27.8%), partial \u2014 12 (66.7%). At the same time, brainstem decompression and regression of hydrocephalus were observed in all cases. Fourteen patients were followed-up. Median follow-up was 8.5 months. Seventeen patients underwent radiotherapy due to predominant partial and subtotal resection. Total focal dose ranged from 50 to 57 Gy in standard fractionation mode. None patient had residual tumor enlargement throughout the follow-up period. There were no lethal outcomes. Conclusion. Endoscopic transnasal access to clival meningiomas in appropriate anatomical features of tumor and surrounding structures is a full-fledged alternative to transcranial treatment in these patients. This approach provides total resection and brainstem decompression. 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