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KMID : 0942820090080020165
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Journal of Korean Brain Tumor Society
2009 Volume.8 No. 2 p.165 ~ p.169
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Surgical Management of Large Clinoidal Meningiomas
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Roh Tae-Hoon
Hong Chang-Ki
Kim Chang-Hyun
Ahn Jung-Yong
Chang Jong-Hee
Lee Kyu-Sung
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Abstract
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Objective: Clinoidal meningiomas represent a surgical challenge. The purpose of this study was to analyze our clinical experience with clinoidal meningiomas.
Methods: A retrospective analysis was performed on data obtained in 23 consecutive patients with large clinoidal meningiomas who underwent surgical resection at our hospital between August 1999 and June 2008. All patients underwent surgery through the pterional approach with zygomatic osteotomy. A skull base approach with combined extra- and intradural anterior clinoidectomy was used in 8. The follow-up period ranged from 14 to 120 months(56.3±8.8 months).
Results: The mean tumor size was 4.82(±1.62) cm. A gross total resection was accomplished in all patients. Seven patients(30.4%) had giant tumor(largest diameter>6 cm). Nineteen patients(82.6%) had a good outcome, one had a mild hemiparesis because of postoperative epidural hematoma, but she was fully recovered after the physical ehabilitation. Three patients(13.0%) developed third nerve palsy after surgical removal. One(4.3%) of the 23 tumors recurred during follow-up and was retreated with surgery. Twelve patients(52.2%) had significant visual deficits preoperatively, and the majority of the patients experienced significant visual improvement.
Conclusion: The primary goals of surgery are to achieve aggressive tumor removal with avoidance of morbidity and mortality. With the use of the skull base technique, total resection and excellent visual outcome may be achieved with minimal morbidity in most patients with clinoidal meningiomas.
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KEYWORD
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Anterior clinoid process, Meningioma, Skull base, Sphenoid wing, Surgery
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