Download PDF
J Neurol Surg B Skull Base 2021; 82(06): 624-630
DOI: 10.1055/s-0040-1715523
Original Article

Medial Extension of Medial Sphenoid Wing Meningioma from the Anterior Clinoid Line: Does It Truly Affect the Surgical Outcome?

Ala Arab
1   Department of Neurosurgery, National Neurosciences Institute, King Fahad Medical City, Riyadh, Saudi Arabia
2   Neurosurgery Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
,
Aysha Hawsawi
1   Department of Neurosurgery, National Neurosciences Institute, King Fahad Medical City, Riyadh, Saudi Arabia
3   Neurosurgery Department, King Khalid University Hospital, Riyadh, Saudi Arabia
,
Mohammed Bafaquh
1   Department of Neurosurgery, National Neurosciences Institute, King Fahad Medical City, Riyadh, Saudi Arabia
,
Yasser Orz
1   Department of Neurosurgery, National Neurosciences Institute, King Fahad Medical City, Riyadh, Saudi Arabia
,
Mahmoud AlYamany
1   Department of Neurosurgery, National Neurosciences Institute, King Fahad Medical City, Riyadh, Saudi Arabia
,
Abdullah Alobaid
1   Department of Neurosurgery, National Neurosciences Institute, King Fahad Medical City, Riyadh, Saudi Arabia
› Author Affiliations Funding None.
› Further Information
    Permissions and Reprints

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.

Keywords

sphenoid wing - meningioma - outcome - anterior clinoid line

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

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 DeMonte F, Mcdermott M, Al-Mefty Oeds. Al Mefty Meningioma. 2nd ed. New York, NY: Thieme; 2011: 228-236
    Google Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 6 Al-Mefty O. Clinoidal meningiomas. J Neurosurg 1990; 73 (06) 840-849
    CrossrefPubMedGoogle Scholar
  • 7 Alam S, Chaurasia BK, Shalike N. et al. Surgical management of clinoidal meningiomas: 10 cases analysis. Neuroimmunol Neuroinflamm 2018; 5 (05) 21
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 10 Day JD. Cranial base surgical techniques for large sphenocavernous meningiomas: technical note. Neurosurgery 2000; 46 (03) 754-759 , discussion 759–760
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 12 Risi P, Uske A, de Tribolet N. Meningiomas involving the anterior clinoid process. Br J Neurosurg 1994; 8 (03) 295-305
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar