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DOI: 10.1055/s-0040-1715523
Medial Extension of Medial Sphenoid Wing Meningioma from the Anterior Clinoid Line: Does It Truly Affect the Surgical Outcome?
Funding None.![](https://www.thieme-connect.de/media/jnlsb/202106/lookinside/thumbnails/10-1055-s-0040-1715523_200022-1.jpg)
Abstract
Background Medial sphenoid wing meningiomas (MSWMs) account for approximately 20% of all meningiomas that are known for their critical relation to neurovasculture structures.
Objective The purpose of this study is to examine the relation between the maximum diameter of the MSWM medial to the anterior clinoidal line (AC line) and surgical outcome.
Methods This is a retrospective cohort study investigating all surgically resected MSWM cases at our institution over 10 years. The patients were divided into groups A and B based on the average ratio between the maximum medial extension of the MSWM from the AC line to the maximum diameter of the tumor, that is, value I = 0.42 (group A ≤ 0.42 and group B > 0.42). And into groups C and D based on the average medial extension of the tumor, that is, 14 mm (group C ≤ and D group D > 14 mm). These measurements were correlated with patients' demographics, preoperative symptoms, and postoperative assessment.
Results Among 150 patients, 51patients had MSWM that fulfilled the inclusion criteria. Among them, 76.47% were females with a median age of 48 years (standard deviation [SD] = 47.75 ± 15.11). Also, 92% of the cases were World Health Organization (WHO) grade I. The follow-up period was 0.5 to 10 years. Among them, 40% of group C had gross total resection (GTR), whereas 43% in group D. In group B, 70% had GTR, whereas 48% had GTR in group A. None of the patients developed statistically significant postoperative complications. There is no statistically significant difference in the risk complication with medial extension in all groups.
Conclusion The degree of medial extension of MSWM from the AC line has no statistically significant correlation with major postoperative complications, extent of resection, or clinical outcome.
Note
Portions of this work were presented in abstract form as an oral presentation in the North American Skull Base Society 28th Annual Meeting, Coronado, California, United States, February 17, 2018.
Publication History
Received: 31 January 2020
Accepted: 28 June 2020
Article published online:
02 March 2021
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References
- 1 DeMonte F, Mcdermott M, Al-Mefty Oeds. Al Mefty Meningioma. 2nd ed. New York, NY: Thieme; 2011: 228-236
- 2 Abdel-Aziz KM, Froelich SC, Dagnew E. et al. Large sphenoid wing meningiomas involving the cavernous sinus: conservative surgical strategies for better functional outcomes. Neurosurgery 2004; 54 (06) 1375-1383 , discussion 1383–1384
- 3 Liu DY, Yuan XR, Liu Q. et al. Large medial sphenoid wing meningiomas: long-term outcome and correlation with tumor size after microsurgical treatment in 127 consecutive cases. Turk Neurosurg 2012; 22 (05) 547-557
- 4 Nakamura M, Roser F, Jacobs C, Vorkapic P, Samii M. Medial sphenoid wing meningiomas: clinical outcome and recurrence rate. Neurosurgery 2006; 58 (04) 626-639 , discussion 626–639
- 5 Sughrue ME, Rutkowski MJ, Chen CJ. et al. Modern surgical outcomes following surgery for sphenoid wing meningiomas. J Neurosurg 2013; 119 (01) 86-93
- 6 Al-Mefty O. Clinoidal meningiomas. J Neurosurg 1990; 73 (06) 840-849
- 7 Alam S, Chaurasia BK, Shalike N. et al. Surgical management of clinoidal meningiomas: 10 cases analysis. Neuroimmunol Neuroinflamm 2018; 5 (05) 21
- 8 Attia M, Umansky F, Paldor I, Dotan S, Shoshan Y, Spektor S. Giant anterior clinoidal meningiomas: surgical technique and outcomes. J Neurosurg 2012; 117 (04) 654-665
- 9 Behari S, Giri PJ, Shukla D, Jain VK, Banerji D. Surgical strategies for giant medial sphenoid wing meningiomas: a new scoring system for predicting extent of resection. Acta Neurochir (Wien) 2008; 150 (09) 865-877 , discussion 877
- 10 Day JD. Cranial base surgical techniques for large sphenocavernous meningiomas: technical note. Neurosurgery 2000; 46 (03) 754-759 , discussion 759–760
- 11 Goel A, Gupta S, Desai K. New grading system to predict resectability of anterior clinoid meningiomas. Neurol Med Chir (Tokyo) 2000; 40 (12) 610-616 , discussion 616–617
- 12 Risi P, Uske A, de Tribolet N. Meningiomas involving the anterior clinoid process. Br J Neurosurg 1994; 8 (03) 295-305
- 13 Tomasello F, de Divitiis O, Angileri FF, Salpietro FM, d'Avella D. Large sphenocavernous meningiomas: is there still a role for the intradural approach via the pterional-transsylvian route?. Acta Neurochir (Wien) 2003; 145 (04) 273-282 , discussion 282
- 14 Kallio M, Sankila R, Hakulinen T, Jääskeläinen J. Factors affecting operative and excess long-term mortality in 935 patients with intracranial meningioma. Neurosurgery 1992; 31 (01) 2-12
- 15 Pamir MN, Belirgen M, Özduman K, Kiliç T, Özek M. Anterior clinoidal meningiomas: analysis of 43 consecutive surgically treated cases. Acta Neurochir (Wien) 2008; 150 (07) 625-635 , discussion 635–636