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Surgical management of clinoidal meningiomas.
- Source :
-
Neurosurgery [Neurosurgery] 2001 May; Vol. 48 (5), pp. 1012-9; discussion 1019-21. - Publication Year :
- 2001
-
Abstract
- Objective: Surgical outcome has been less than desirable in the management of patients with clinoidal meningiomas in the past, and little attention has been directed at improving their visual function. The purpose of this article is to advocate an available cranial base technique for removing these difficult tumors and to delineate the technique's advantages that aid in achieving an improved extent of tumor resection and enhancing the patients' overall outcome, particularly their visual outcome.<br />Methods: A retrospective analysis was performed on 15 consecutive patients with clinoidal meningiomas (including a patient with hemangiopericytoma) who underwent surgical resection at the Cleveland Clinic Foundation between June 1995 and January 2000. A cranial base technique consisting of extradural anterior clinoidectomy, coupled with optic canal unroofing and optic sheath opening, was used in 13 patients, and standard pterional craniotomy was used in 2. Eight of 15 patients had significant visual deficits preoperatively. All patients had thorough preoperative and postoperative ophthalmological evaluations. The follow-up period ranged from 6 to 60 months (mean, 37.2 mo).<br />Results: Total resection was achieved in 13 (86.7%) of the 15 patients in this series, and the majority of the patients with preoperative visual impairment experienced significant improvement (6 of 8 patients; 75%).<br />Conclusion: In the majority of patients with clinoidal meningiomas, total resection may be achieved with minimal complications. For large tumors encasing the optic nerve and internal carotid artery, or for those tumors causing preoperative visual impairment, use of the cranial base technique delineated in this study may lead to significant improvement in the patients' visual and overall outcomes.
- Subjects :
- Adolescent
Adult
Aged
Female
Humans
Magnetic Resonance Imaging
Male
Meningeal Neoplasms diagnosis
Meningeal Neoplasms physiopathology
Meningioma diagnosis
Meningioma physiopathology
Middle Aged
Neoplasm Recurrence, Local
Nervous System physiopathology
Neurosurgery methods
Postoperative Complications
Postoperative Period
Retrospective Studies
Sphenoid Bone
Visual Acuity
Visual Fields
Meningeal Neoplasms surgery
Meningioma surgery
Subjects
Details
- Language :
- English
- ISSN :
- 0148-396X
- Volume :
- 48
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 11334267
- Full Text :
- https://doi.org/10.1097/00006123-200105000-00009