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Extended Pterional Approach for Medial Sphenoid Wing Meningioma: A Series of 47 Patients
Jose Carlos Lynch1, Celestino Esteves Pereira1, Mariangela Gonçalves1
1Departmnet of Neurosurgery, Public Servants Hospital, Rio de Janeiro, RJ, Brazil.
Abstract:
Background To describe our operative strategy and analyze its safety and effectiveness for the removal of medial sphenoid wing meningiomas (MSWMs) through the extended pterional approach. Method We identified 47 patients with MSWMs who were operated using this approach between 1986 and 2016. Medical charts, operative reports, imaging results, and clinical follow-up evaluations were reviewed and retrospectively analyzed. Results No surgical mortality was observed in this sample. Gross total resection was achieved in 30 (63.8%) patients. Intradural clinoidectomy was performed in 16 (34%) patients. The median length of follow-up was 8.5 years (range, 1-30 years). Conclusion The extended pterional approach associated with microsurgery techniques provided excellent results for the removal of MSWMs.
Insights
The extended pterional approach is a safe and effective surgical method for removing medial sphenoid wing meningiomas (MSWMs). This microsurgical technique achieved gross total resection in most patients without any surgical mortality.
Area of Science:
- Neurosurgery
- Surgical Oncology
Background:
- Medial sphenoid wing meningiomas (MSWMs) present unique surgical challenges.
- The extended pterional approach is a specialized technique for accessing these tumors.
Purpose of the Study:
- To detail the operative strategy for MSWM removal using the extended pterional approach.
- To evaluate the safety and efficacy of this surgical method.
Main Methods:
- Retrospective analysis of 47 patients with MSWMs operated between 1986 and 2016.
- Review of medical charts, operative reports, imaging, and clinical follow-up data.
Main Results:
- No surgical mortality was recorded in the study cohort.
- Gross total resection was achieved in 63.8% of patients.
- Intradural clinoidectomy was performed in 34% of cases, with a median follow-up of 8.5 years.
Conclusions:
- The extended pterional approach, combined with microsurgical techniques, yields excellent outcomes for MSWM resection.
- This approach offers a safe and effective strategy for managing medial sphenoid wing meningiomas.
