Association of morbidity with extent of resection and cavernous sinus invasion in sphenoid wing meningiomas.
Sphenoid wing meningiomas (SWMs) typically are histologically benign, insidious lesions, but the propensity of these tumors for local invasion makes disease control very challenging. In this review, we assess whether the degree of resection and extent of cavernous sinus invasion affects morbidity, mortality, and recurrence in patients with SWM. A comprehensive search of the English-language literature was performed. Patients were stratified according to extent of resection and extent of cavernous sinus invasion, and tumor recurrence rate, morbidity, and mortality were analyzed. A total of 23 studies and 131 patients were included. Overall recurrence and surgical mortality rate were 11% and 2%, respectively (average follow-up = 65 months). Cranial nerve III palsy was significantly associated with incompletely versus completely resected SWMs (7 to 0%) as well as meningiomas with cavernous sinus invasion versus no sinus invasion (14 vs. 0%). No significant difference in tumor recurrence rate was noted between these groups. In conclusion, complete excision of SWMs is always recommended whenever possible, but surgeons should acknowledge that there is nonetheless a chance of recurrence and should weigh this against the risk of causing cranial nerve injuries.
Department of Neurological Surgery, University of California, San Francisco, California.
Michael E
ME
Ivan
Jason S
JS
Cheng
Gurvinder
G
Kaur
Michael E
ME
Sughrue
Aaron
A
Clark
Ari J
AJ
Kane
Derick
D
Aranda
Michael
M
McDermott
Igor J
IJ
Barani
Andrew T
AT
Parsa
meningioma; morbidity; prognosis; sphenoid; sphenoid meningiomas; tumor control