title: [Experience of resection large clinoidal meningiomas].
abstract: OBJECTIVE
  To investigate the clinical applied anatomy in the region of anterior clinoid process, and to improve the therapeutic efficacy of clinoidal tumors.
  
  
  METHODS
  Twelve patients with large meningiomas located in clinoid were surgically treated via the extended anterior and middle fossa combined with epidural approach between January 1998 and August 2004. The surgical outcome and follow-up results were reviewed retrospectively. Supraorbital-posterional approach and cranioorbital zygomatic approach were used when tumors involved cavernous sinus. Anterior clinoid process was grinded with high-speed drilling. Supply of tumors were blocked extradurally. Tumors were resected intradurally.
  
  
  RESULTS
  Of the 12 cases in large meningiomas located in clinoid, 8 cases had total removal of tumors, 3 patients had subtotal removal. Of the 10 patients with pre-operative severe visual deterioration, 6 patients was markedly improved, one patient unchanged and one patient worsened post-operatively. No death was found in this group.
  
  
  CONCLUSIONS
  Using epidural approach for clinoidal meningiomas and grinding anterior clinoid process was advantageous to block tumors base blood supply and detach infraclinoidal tumors from internal carotid artery. Supraorbital-pterional approach could minimize brain retraction and was advantageous to expose superior pole of giant tumors.
authors.affiliation: Department of Neurosurgery, 359th Hospital, Chinese People's Liberation Army, Zhenjiang 212001, China. taocunshan1968@163.com
authors.forename: Cun-shan
authors.initials: CS
authors.lastname: Tao
authors.forename: Mei-qing
authors.initials: MQ
authors.lastname: Lou
authors.forename: Yi-cheng
authors.initials: YC
authors.lastname: Lu
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.forename: Bing-xin
authors.initials: BX
authors.lastname: Wang
authors.forename: Wen
authors.initials: W
authors.lastname: Li
authors.forename: Kang
authors.initials: K
authors.lastname: Zhang
authors.forename: Jian-hua
authors.initials: JH
authors.lastname: Jiang
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D013100:Sphenoid Bone / Q000601:surgery; D016896:Treatment Outcome