Giant planum sphenoidale meningioma: rationale for Dolenc's step in the pterional approach

Akshohini Garg ¹, Kuntal Kanti Das ¹, Sudarsana Gogoi ²

⁰Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow; and.

Neurosurgical Focus: Video +

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January 22, 2026

View abstract on PubMed

Summary

Giant planum sphenoidale meningiomas pose risks to olfactory and visual functions. The pterional approach with Dolenc

Area Of Science

Neurosurgery
Skull Base Surgery
Oncology

Background

Large midline anterior skull base meningiomas can compromise adjacent neurological structures.
Giant planum sphenoidale meningiomas present a unique challenge due to their proximity to olfactory and optic pathways.

Purpose Of The Study

To evaluate the efficacy and advantages of the pterional approach with Dolenc's modification for resecting giant planum sphenoidale meningiomas.
To highlight the technique's ability to preserve olfactory and visual functions.

Main Methods

Surgical technique utilizing a pterional approach with Dolenc's modification.
Complete extradural anterior clinoidectomy for early optic nerve decompression.
Exposure of the basal internal carotid artery to expand the operative corridor.

Main Results

The pterional approach with Dolenc's modification facilitates a more basal angle of attack for tumor resection.
Improved visualization of the anterior-to-posterior expanse of the anterior skull base.
Enhanced ergonomics for tumor resection, potentially leading to improved functional outcomes.

Conclusions

The pterional approach with Dolenc's modification is advantageous for managing giant planum sphenoidale meningiomas.
This technique allows for early decompression of critical neurovascular structures.
It offers an expanded operative corridor and improved visualization for safe and effective tumor removal.

Keywords:

anterior clinoidectomy olfaction optic canal unroofing unilateral transcranial approach

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