AI Article Synopsis
- Intracranial meningiomas involving bones and primary intraosseous meningiomas are rare, with no clear guidelines for treatment; this study reviews strategies and outcomes over a decade.
- A retrospective analysis of 33 adult patients reveals that most had secondary bone involvement, with many undergoing cranioplasty using various materials like polymethyl methacrylate and titanium mesh, showing a high success rate.
- The findings suggest that while different cranioplasty materials were effective, those that are pre-fabricated may lead to fewer complications, indicating the need for further research in this area.
Article Abstract
Background: Intracranial meningioma with bone involvement and primary intraosseous meningioma is uncommon. There is currently no consensus for optimal management. This study aimed to describe the management strategy and outcomes for a 10-year illustrative cohort, and propose an algorithm to aid clinicians in selecting cranioplasty material in such patients.
Methods: A single-centre, retrospective cohort study (January 2010-August 2021). All adult patients requiring cranial reconstruction due to meningioma with bone involvement or primary intraosseous meningioma were included. Baseline patient and meningioma characteristics, surgical strategy, and surgical morbidity were examined. Descriptive statistics were performed using SPSS v24.0. Data visualisation was performed using R v4.1.0.
Results: Thirty-three patients were identified (mean age 56 years; SD 15) There were 19 females. Twenty-nine patients had secondary bone involvement (88%). Four had primary intraosseous meningioma (12%). Nineteen had gross total resection (GTR; 58%). Thirty had primary 'on-table' cranioplasty (91%). Cranioplasty materials included pre-fabricated polymethyl methacrylate (pPMMA) (n = 12; 36%), titanium mesh (n = 10; 30%), hand-moulded polymethyl methacrylate cement (hPMMA) (n = 4; 12%), pre-fabricated titanium plate (n = 4; 12%), hydroxyapatite (n = 2; 6%), and a single case combining titanium mesh with hPMMA cement (n = 1; 3%). Five patients required reoperation for a postoperative complication (15%).
Conclusion: Meningioma with bone involvement and primary intraosseous meningioma often requires cranial reconstruction, but this may not be evident prior to surgical resection. Our experience demonstrates that a wide variety of materials have been used successfully, but that pre-fabricated materials may be associated with fewer postoperative complications. Further research within this population is warranted to identify the most appropriate operative strategy.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10140130 | PMC |
| http://dx.doi.org/10.1007/s00701-023-05535-4 | DOI Listing |
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