Role of Planum Sphenoidale Meningioma Resection in Improving Visual Function

Introduction: The planum sphenoidale (or jugum sphenoidale) is the planar surface of the sphenoid bone connecting the two lesser wings, and lies anterior to the sella turcica. Together with the anterior clinoid processes, it forms the roof of the sphenoid sinus. It marks the posterior limit of the anterior skull base, and meningiomas that arise from this site are known as planum sphenoidale meningiomas. With the proximity of such lesions to vital structures like the optic apparatus and pituitary gland, clinical features have been noted to include visual impairment and hormonal deficiencies.

Methods: We retrospectively reviewed the clinical records of 17 patients with planum sphenoidale meningiomas who were admitted to our center between 2004 and 2011. Patients had formal visual assessments (including Humphrey’s visual field testing) pre- and postoperatively.

Results: The mean age at presentation was 62.3 years; there were 11 women and 6 men. The meningiomas ranged in diameter from 17 mm to 70 mm (mean diameter 37.2 mm). Twelve of the patients had neurosurgical intervention (seven of these had a pterional approach, three had a bicoronal frontal approach, and two had the tumor resected via the transglabellar frontal approach). Histological analysis showed nine of the cases were WHO grade I and the remaining three were grade II.

Ten of the patients demonstrated improvement in their visual acuity assessment, and four of the patients had no demonstrable visual impairment preoperatively.

Conclusions: Prevention of visual deterioration and/or improvement of visual function remain benefits that could be attained by resection of planum sphenoidale meningioma. Pre- and postoperative formal ophthalmological assessments should be an integral component in the management of these tumors.