Abstract
Large to giant sphenoid wing meningiomas (SWMs) remain surgically challenging due to frequent vascular encasement and a tendency for tumoral invasion of the cavernous sinus and optic canal. We aimed to study the quality of resection, postoperative clinical evolution, and recurrence rate of large SWMs. This retrospective study enrolled 21 patients who underwent surgery between January 2014 and December 2019 for SWMs > 5 cm in diameter (average 6.3 cm). Tumor association with cerebral edema, extension into the cavernous sinus or optic canal, degree of encasement of the major intracranial arteries, and tumor resection grade were recorded. Cognitive decline was the most common symptom (65% of patients), followed by visual decline (52%). Infiltration of the cavernous sinus and optical canal were identified in five and six patients, respectively. Varying degrees of arterial encasement were seen. Gross total resection was achieved in 67% of patients. Long-term follow-up revealed improvement in 17 patients (81%), deterioration in two patients (9.5%), and one death (4.7%) directly related to the surgical procedure. Seven patients displayed postoperative tumor progression and two required reintervention 3 years post initial surgery. Tumor size, vascular encasement, and skull base invasion mean that, despite technological advancements, surgical results are dependent on surgical strategy and skill. Appropriate microsurgical techniques can adequately solve arterial encasement but tumor progression remains an issue.
Highlights
Meningiomas are the most common benign intracranial tumor, representing up to 18% of all intracranial tumor pathologies
We considered en plaque meningiomas, cavernous such, patients with these categories of tumor were excluded. sinus meningiomas, anterior clinoid meningiomas, and extensions of petroclival meningiomas to represent different pathologies, and as Evaluation such, patientsand with these categories of tumor were excluded
Between January 2014 and December 2019, 83 patients diagnosed with sphenoid wing meningiomas (SWMs) underwent surgery in the Neurosurgery Department of the Emergency Clinical Hospital in Tîrgu Mures, Romania
Summary
Meningiomas are the most common benign intracranial tumor, representing up to 18% of all intracranial tumor pathologies. Sphenoid wing meningiomas (SWMs) account for up to one-quarter [1,2,3,4,5,6,7,8]. Meningiomas are slow growing and over 90% are benign lesions Organization grade 1) that do not infiltrate surrounding structures. Symptomatology onset is insidious and, the clinical presentation, surgical risk, and prognosis can vary from case to case [1,3,9,10,11,12,13]. Meningiomas originating along the sphenoidal ridge were first classified by Cushing and Eisenhardt as medial, middle, and lateral SWMs (Figure 1) [14].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
