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Meningiomas involving the anterior clinoid process
P Risi1, A Uske, N de Tribolet
1Department of Neurosurgery, University Hospital (CHUV), Lausanne, Switzerland.
British Journal of Neurosurgery
|January 1, 1994
Summary
Surgical treatment of clinoidal meningiomas offers good outcomes, with total resection preventing recurrence. Aggressive surgery is recommended for progressive visual impairment, especially with cavernous sinus involvement.
Area of Science:
- Neurosurgery
- Oncology
Background:
- Clinoidal meningiomas are tumors arising from the sphenoid bone's clinoid processes.
- Surgical management is the primary treatment modality for these tumors.
Purpose of the Study:
- To analyze surgical outcomes of clinoidal meningiomas.
- To evaluate the impact of cavernous sinus involvement on surgical results.
- To assess the efficacy of aggressive surgical approaches for visual impairment.
Main Methods:
- Retrospective analysis of 34 surgically treated clinoidal meningiomas.
- Classification of tumors based on cavernous sinus involvement.
- Evaluation of resection extent, complications, recurrence, and visual outcomes.
Main Results:
- 20 tumors had total resection, 14 had partial resection.
- Complete resection was achieved in 4/15 tumors with cavernous sinus involvement.
- Postoperative complications included transient CSF leak (3 patients) and permanent complications (3 patients).
- No recurrence after total removal; 5/14 partial resections showed progression.
- Visual improvement or stability occurred in 68% of patients with preoperative visual impairment.
Conclusions:
- Total resection of clinoidal meningiomas is associated with favorable outcomes and no recurrence.
- Aggressive surgical strategies, including anterior clinoidectomy and zygomatic arch resection, facilitate tumor devascularization and minimize brain retraction.
- Progressive visual impairment warrants aggressive surgical intervention, particularly when complete resection of cavernous sinus involvement is feasible.