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Updated: Apr 23, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Management of large medial sphenoid wing meningiomas: a series of 178 cases
Ji Zhang1, Rajendra Shrestha, Bo-Wen Cai
1Sun Yat-sen University Cancer Center, Department of Neurosurgery, Guangzhou, P. R. China.
Aim:
The aim of this study was to evaluate our treatment and outcome in patients with large medial sphenoid wing meningiomas (SWMs).
Material And Methods:
Data from 178 patients with large medial SWMs treated was collected and analyzed retrospectively. Most of patients underwent microsurgical resection under electrophysiological monitoring and Doppler probe. Radiation therapy was administered in 64 patients with residual tumor and malignant pathology.
Results:
Total resection of the tumor was achieved in 118 of 178 cases (66.3%), subtotal in 60 of 178 (33.7%) at the time of initial surgery without serious surgical complications except 2 patients with ptosis. Postoperative vision improved in 84 patients (87.5%), remained unchanged in 8 (8.3%) and deteriorated in 4 (4.2%). The progress free survival (PFS) and Karnofsky performance score (KPS) between patients with gross total resection (GTR) and patients with subtotal resection (STR) followed by radiation therapy (RT) had no significant difference.
Conclusion:
Surgery still remains a principal treatment option for SWMs. Good craniotomy techniques, proper hemostasis and optimal surgery strategy are critical to improve resection rate and elevate prognosis. Likewise, it is expected that STR with adjuvant RT can provide satisfactory results in case of total removal impossible.
Insights
Microsurgery is the primary treatment for large sphenoid wing meningiomas (SWMs), achieving high resection rates and good outcomes. Subtotal resection with radiation therapy offers satisfactory results when complete removal is not feasible.
Area of Science:
- Neurosurgery
- Oncology
Background:
- Large medial sphenoid wing meningiomas (SWMs) present significant surgical challenges.
- Evaluating treatment strategies and outcomes for SWMs is crucial for improving patient prognosis.
Purpose of the Study:
- To assess the treatment outcomes for patients with large medial sphenoid wing meningiomas (SWMs).
- To identify factors influencing surgical success and patient recovery.
Main Methods:
- Retrospective analysis of 178 patients with large medial SWMs.
- Microsurgical resection with electrophysiological monitoring and Doppler probe.
- Adjuvant radiation therapy for residual tumors or malignant pathology.
Main Results:
- Gross total resection (GTR) achieved in 66.3% of cases; subtotal resection (STR) in 33.7%.
- Postoperative vision improved in 87.5% of patients.
- No significant difference in progression-free survival or Karnofsky performance score between GTR and STR with radiation therapy.
Conclusions:
- Surgical resection remains the principal treatment for SWMs.
- Optimal surgical techniques and strategy are key to maximizing resection rates and prognosis.
- Subtotal resection combined with adjuvant radiation therapy is a viable option when complete resection is not possible.
