Medial sphenoid wing meningiomas: clinical outcome and recurrence rate.
OBJECTIVE
To provide clinical data concerning the visual outcome and recurrence rate of medial sphenoid wing meningiomas in consideration of two different subgroups of this tumor entity.


METHODS
Among 256 sphenoid wing meningiomas, there were 108 medial sphenoid wing meningiomas of globoid shape. They were classified into Group 1 (without cavernous sinus involvement) and Group 2 (with cavernous sinus involvement). En plaque meningiomas were excluded from the analysis. The charts of the patients including surgical records, discharge letters, follow-up records, and imaging studies were analyzed retrospectively.


RESULTS
There were 39 Group 1 tumors and 69 Group 2 tumors. For microsurgical tumor removal, the frontolateral (15.7%) or the pterional approach (84.3%) was performed. Total resection was achieved in 92.3% of patients with Group 1 tumors and 14.5% of those with Group 2 tumors. Radiological recurrence was observed in 7.7% (Group 1 tumors) and 27.5% (Group 2 tumors). The mean follow-up time was 79.04 months (6.59 yr). Improvement of visual function (or stable visual function) was observed in 56% (44%) of patients with Group 1 tumors, in 30% (60%) with newly diagnosed Group 2 tumors, and 10% (70%) undergoing recurrent surgery for Group 2 tumors.


CONCLUSIONS
Group 1 meningiomas present a more favorable subgroup with fortunate visual outcome. In Group 2 tumors, visual improvement was less favorable and radical removal is limited because of cavernous sinus infiltration, with consequential higher recurrence rates. Patients harboring recurrent Group 2 tumors with deteriorating visual function profit from microsurgery because vision can be preserved on the same preoperative level in the majority.
Nakamura
Makoto
M
Department of Neurosurgery, Nordstadt Hospital, Klinikum Hannover, Hannover, Germany. mnakamura@web.de
Roser
Florian
F
Jacobs
Cornelius
C
Vorkapic
Peter
P
Samii
Madjid
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D008579:Meningioma / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D014786:Vision Disorders / Q000000981:diagnostic imaging / Q000601:surgery