Background: The resection of the jugum (planum) sphenoidale meningioma (JSM) is challenging, and there is a scarcity of available data in the literature. This study aimed to describe the surgical management and long-term outcome of jugum sphenoidale meningioma.
Methods: This was a retrospective, single-center, cohort study of 91 JSM patients treated in our department from 2005 to 2022. All the included patients have undergone surgical treatment. Clinical, radiologic, and surgical data were extracted with specific attention to the age at onset, family history, duration from symptoms to diagnosis, clinical presentation, quality of excision, recurrence, and treatment outcome.
Results: WHO grade I and grade II meningioma were 83.5% (n = 76) and 16.5% (n = 15) respectively. Fronto-lateral 42.9% (n = 39) and pterional approaches 57.1% (n = 52) were the 2 major surgical approaches used for the management of planum sphenoidale meningioma. Twelve patients needed emergency surgical treatment at admission: 4 (4.4%) External CSF Shunt and 8 (8.8%) VP-Shunt. We have found a statistically significant (P = 0.032) association between the quality of excision and the risk of recurrence. The GTR (Hazard ratio = 1) of the planum meningioma protects the patient from recurrence within 60 months of follow-up. Postoperative complications encountered were CSF-Leak in 2.2%, Meningitis 4.4%, surgical site infection 2.2%, and surgical site hematoma 3.3%. The overall postoperative favorable outcome was 68.1% (n = 62).
Conclusions: The pterional approach has allowed the achievement of GTR for jugum sphenoidale meningioma with protective odds from recurrence risk.
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http://dx.doi.org/10.1016/j.wneu.2024.02.008 | DOI Listing |
AJNR Am J Neuroradiol
December 2024
From the Department of Neurological Surgery (M.A.E., J.R., I.P., A.F., M.H., D.K., C.C., E.E., N.H., V.A., D.J.A.), Montefiore-Einstein Cerebrovascular Research Lab (M.A.E., D.J.A.), and Department of Radiology (A.B.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Background And Purpose: Preoperative embolization of anterior skull base meningiomas can facilitate surgical resection by reducing tumor vascularity. However, transophthalmic artery embolization carries risks of visual complications. This study aimed to evaluate the safety and efficacy of this technique using modern endovascular tools.
View Article and Find Full Text PDFWorld Neurosurg
December 2024
Neurosurgery Division, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Background: The preservation of olfaction during the surgical resection of anterior skull base meningiomas presents a significant challenge. This study presents a modified endonasal endoscopic L-shaped approach designed to maximize tumor resection while preserving olfaction, a vital function that profoundly impacts the quality of life.
Methods: A cadaveric dissection was conducted to refine the surgical technique, and this approach was subsequently applied to a 34-year-old female patient presenting with a large planum sphenoidale meningioma.
Adv Tech Stand Neurosurg
September 2024
Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Napoli "Federico II", Naples, Italy.
Tuberculum and planum meningiomas are challenging tumors per their critical location and neurovascular relationships. The standard treatment is usually represented by complete tumor removal, being the transcranial approaches the well-established routes. During the last decades, novel surgical routes have been experimented with emphasis on the concept of minimal invasive approaches.
View Article and Find Full Text PDFCan J Neurol Sci
September 2024
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Background: To evaluate clinical outcomes and volumetric changes following endoscopic endonasal approach (EEA) for tuberculum sellae (TS) and planum sphenoidale (PS) meningiomas. Key objectives included evaluating pre- and postoperative tumor volumes, visual assessments and EEA-related complications.
Methods: A single-center retrospective study was conducted at Foothills Medical Centre, University of Calgary, Canada, from 2009 to 2022 including 24 patients meeting inclusion criteria for midline skull base tumors, confirmed as WHO Grade I or II meningiomas with optic canal extension.
Adv Tech Stand Neurosurg
July 2024
Neurosurgery Department, Ibn Sina Hospital, Al-Sabah Medical Area, Kuwait City, Kuwait.
Background: Anterior cranial base meningiomas include those meningiomas originating from the tuberculum sellae, the planum sphenoidale, or the olfactory groove, with surgical excision being the main treatment modality for these tumors. Conventional microscopic and endoscope-assisted versions of the supraorbital keyhole approach via an eyebrow incision emerged into minimally invasive options that are frequently utilized nowadays for treating these tumors. At the early attempts of endoscope-assisted cranial surgery, it was noted that rigid endoscopes enabled overcoming the problem of suboptimal visualization when small exposures are used.
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