Medial Sphenoid Wing Meningiomas: Clinical Outcome and Recurrence Rate

Nakamura, Makoto; Röser, Florian; Jacobs, Cheryl; Vorkapic, Peter; Samii, M.

doi:10.1227/01.neu.0000197104.78684.5d

Cited by 131 publications

(144 citation statements)

References 23 publications

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“…The surgical treatment for recurrence tumor was even more difficult than that in the first time operation (20). In our series, 14 patients had undergone surgery in other center and experienced recurrence, the rate of total removal (71.4%) was lower than the patients performed the first operation (83.2%).…”

Section: Liu D Et Al: Large Medial Sphenoid Wing Meningiomasmentioning

confidence: 64%

“…In small tumors it was usually accessible, while, in large or giant tumors, the tumor infiltrate wildly and more difficulty may be encountered to remove all of the dural and bony attachments radically which may increase the risk of injury of neural structure and exposure-induced complications. Nakanuma et al (20) found that there was no statistically difference of recurrence rate between group with bone removal and group without removal. We considered that heavy coagulation of dural can maybe kill most of even all of the tumor cells and can replace radically resection if no signs of erosion of bone inspected at the surgery and images.…”

Section: Correlation Of Tumor Size With Clinical Characteristics and mentioning

confidence: 94%

“…Al-Mefty(2-4) reported authors (6,9,30-32) proposed a radical and aggressive resection whereas, some authors (5,13,20,21,23,28,35) proposed a conservative strategy with or without following radiosurgery. In our series, total removal was achieved in 104 cases (81.2%), and of 60 cases with CS involvement, 47 were achieved total removal.…”

Section: Neurological Functional Outcomesmentioning

confidence: 99%

“…They are still reported to have the worst neurological functional outcome hindering postoperative quality of life (next to petroclival meningiomas) with highest recurrence rate (2,8,18), partly because of their intricate and intimate relationship with cavernous sinus (CS), arteries of anterior circulation, and optic pathways. As radiosurgery plays an increasing important role in benign tumors, there is much controversy about the indications for aggressive resection of MSWM 1,5,13,20 . It was known that the more aggressive radical resection is achieved, the higher incidence of morbidity and or even mortality would be led to.…”

Section: Introductionmentioning

confidence: 99%

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Large medial sphenoid wing meningiomas: long-term outcome and correlation with tumor size after microsurgical treatment in 127 consecutive cases

Liu

Yuan²,

Liu³

et al. 2012

Turkish Neurosurgery

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AIm:We present the long-term outcomes as well as their correlation with tumor size in 127 consecutive patients harboring large MSWM after microsurgical treatment. mATeRIAL and meTHods:The retrospective analysis of clinical data and follow-up data of 127 microsurgical treated patients with MSWM was performed. The mean maximum diameter of tumors was 5.2cm (ranged 1.5-10.0cm).ResuLTs: 104 cases (81.9%) achieved gross total resection. There was no operative mortality. Detailed follow-up data was available in 120 cases for a mean duration of 81.6 months (12-216 months). The permanent morbidity was 14.2%. The mean KPS score 1 year after surgery was 90.6 (ranged 60-100). Among 74 patients of preoperative visual acuity (VA) impairment, postoperative VA improved in 42 cases (56.8%), unchanged in 30 (40.5%), and deteriorated in 2 (2.7%). MR images revealed tumor recurrence after total resection in 10 cases (10.2%) and tumor progression after subtotal resection in 10 cases (45.5%).CoNCLusIoN: Tumor recurrence was the major risk in the long run, thus the initial surgery was extremely important and hence should be aggressive. The size of tumor affected the extent of tumor removal determining clinical outcomes including VA improvement and KPS score immediately after surgery; however, it was not correlated with long-term overall outcomes. BuLGuLAR: 104 olguda (%81,9) gros total rezeksiyon yapıldı. Operatif mortalite yoktu. Ayrıntılı takip verileri 120 olguda ortalama 81,6 ay (12-216 ay) için mevcuttu. Kalıcı morbidite %14,2 oranında görüldü. Cerrahiden 1 yıl sonra ortalama KPS skoru 90,6 (aralık 60-100) bulundu. Preoperatif görme keskinliği bozukluğu olan 74 hasta içinde postoperatif dönemde görme keskinliği 42 hastada (%56,8) arttı, 30'unda (%40,5) değişmedi ve 2'sinde (%2,7) kötüye gitti. MR görüntüleri total rezeksiyon sonrasında 10 olguda (%10,2) tümör reküransı ve subtotal rezeksiyon sonrasında 10 olguda (%45,5) tümör ilerlemesi gösterdi. soNuÇ: Uzun dönemde temel risk tümör reküransıydı ve bu nedenle ilk cerrahi çok önemlidir ve agresif olmalıdır. Tümör büyüklüğü, tümör çıkarma kapsamını etkileyerek ameliyattan hemen sonra görme keskinliği düzelmesi ve KPS skoru dahil klinik sonuçları etkiledi ancak uzun dönemli genel sonuçlarla korelasyon göstermedi.ANAHTAR sÖZCÜKLeR: Medial sfenoid kanat menenjiyomları, Tümör büyüklüğü, Tümör reküransı, İşlevsel sonuç

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Section: Liu D Et Al: Large Medial Sphenoid Wing Meningiomasmentioning

confidence: 64%

Section: Correlation Of Tumor Size With Clinical Characteristics and mentioning

confidence: 94%

Section: Neurological Functional Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Large medial sphenoid wing meningiomas: long-term outcome and correlation with tumor size after microsurgical treatment in 127 consecutive cases

Liu

Yuan²,

Liu³

et al. 2012

Turkish Neurosurgery

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“…Even if a large bony segment is removed, there will be no need to make a bony reconstruction soon (4). Whatever the type of the sphenoid wing meningioma, the authors invariably report the trick of the surgical technique as removal of the sphenoid wing after providing a good anatomical orientation for SOF and the related area (10,15,19,24,27).…”

Section: Discussionmentioning

confidence: 99%

Does the sphenoid angle effect the operation strategy?anatomical and radiological investigation

Kahiloğulları¹,

Uz²,

Eroğlu³

et al. 2012

Turkish Neurosurgery

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AIm:The aim of our study is to suggest the sphenoid wing-lesser wing angulation (SWA) importance during surgeries directed to this region. mATeRIAL and meTHods: SWA on 40 skulls were measured bilaterally (n=80). The depth of the middle cranial fossa (DMCF) at the level of the SWA was determined. The same measurements were done on 40 randomly selected computerized tomography (CT) scans bilaterally (n=80). ResuLTs:The specimens were classified into 3 groups according the degree of SWA; Group-A, SWA was more than 130° (27%), Group-B, SWA was 110-130° (43%) and Group-C, SWA was less than 110° (28%). MCF was measured (mean) as 10.1 mm in Group-A, 6.4 mm in Group-B and 4.6 mm in Group-C. MCF was increasing with the increase in SWA. CT scans were classified into same procedure. Group-A was 26%, Group-B was 42% and Group-C was 31% fitting in the relevant groups. The superior orbital fissure (SOF) was evaluated according to the Sharma's classification. CoNCLusIoN:We suggest that by the preoperative evaluation of CT scans measurements the SWA, it is possible to estimate the MCF and the type of SOF. This knowledge may be important for all surgeries requiring removal of the sphenoid wing and these region pathologies.

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Anatomic study of the prechiasmatic sulcus and its surgical implications

et al. 2010

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To address a lack of anatomical descriptions in the literature regarding the prechiasmatic sulcus, we conducted an anatomical study of this sulcal region and discuss its clinical relevance to cranial base surgery. Our systematic morphometric analysis includes the variable types of chiasmatic sulcus and a classification schema that has surgical implications. We examined the sulcal region in 100 dry skulls; bony relationships measured included the interoptic distance, sulcal length/width, planum sphenoidale length, and sulcal angle. The varied anatomy of the prechiasmatic sulcii was classified as four types in combinations of wide to narrow, steep to flat. Its anterior border is the limbus sphenoidale at the posterior aspect of the planum sphenoidale. The sulcus extends posteriorly to the tuberculum sellae and laterally to the posteromedial aspect of each optic strut. Averages included an interoptic distance (19.3 +/- 2.4 mm), sulcal length (7.45 +/- 1.27 mm), planum sphenoidale length (19 +/- 2.35 mm), and sulcal angle (31 +/- 14.2 degrees). Eighteen percent of skulls had a chiasmatic ridge, a bony projection over the chiasmatic sulcus. The four types of prechiasmatic sulcus in our classification hold potential surgical relevance. Near the chiasmatic ridge, meningiomas may be hidden from the surgeon's view during a subfrontal or pterional approach. Preoperative evaluation by thin-cut CT scans of this region can help detect this ridge.

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Medial Sphenoid Wing Meningiomas: Clinical Outcome and Recurrence Rate

Cited by 131 publications

References 23 publications

Large medial sphenoid wing meningiomas: long-term outcome and correlation with tumor size after microsurgical treatment in 127 consecutive cases

Large medial sphenoid wing meningiomas: long-term outcome and correlation with tumor size after microsurgical treatment in 127 consecutive cases

Does the sphenoid angle effect the operation strategy?anatomical and radiological investigation

Anatomic study of the prechiasmatic sulcus and its surgical implications

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