title: Medial sphenoid wing meningiomas: Experience with microsurgical resection over 5 years and a review of literature.
abstract: BACKGROUND
  Medial sphenoid wing meningiomas are medially located tumors on the sphenoid wing with attachment over the anterior clinoid process. They represent a distinct entity. These medial sphenoid wing meningiomas present a more difficult problem for the neurosurgeons because in a majority of cases, they involve the anterior visual pathways and arteries of the anterior circulation and may invade the cavernous sinus (CS). Higher morbidity, mortality and recurrence rates have been observed in these tumors compared with meningiomas in other locations. The rate of recurrence for medial sphenoid wing meningiomas is reported as being one of the highest amongst intracranial meningiomas.
  
  
  METHODS
  The authors retrospectively analyzed 78 consecutive patients with the diagnosis of medial sphenoid wing meningioma who were operated in our department from January 2008 to December 2012.
  
  
  RESULTS
  These patients, having a meningioma of the medial sphenoid ridge, were divided into two types depending on the involvement of CS. Diplopia, internal carotid artery encasement, and postoperative visual deterioration were more common in Type 2 tumors. Similarly, extent of resection and postoperative morbidity were greater in Type 2 patients.
  
  
  CONCLUSIONS
  CS invasion confers an added risk to the surgical morbidity and outcomes. However, with proper surgical techniques, optimum outcomes can be achieved and overall surgical results at our center are found to be comparable to that of the current literature.
authors.forename: Satish Kumar
authors.initials: SK
authors.lastname: Verma
authors.affiliation: Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sumit
authors.initials: S
authors.lastname: Sinha
authors.forename: Dattaraj Parmanand
authors.initials: DP
authors.lastname: Sawarkar
authors.forename: Pankaj Kumar
authors.initials: PK
authors.lastname: Singh
authors.forename: Deepak
authors.initials: D
authors.lastname: Gupta
authors.forename: Deepak
authors.initials: D
authors.lastname: Agarwal
authors.forename: Gurudatta
authors.initials: G
authors.lastname: Satyarthee
authors.forename: Rajinder
authors.initials: R
authors.lastname: Kumar
authors.forename: Manmohanjit
authors.initials: M
authors.lastname: Singh
authors.forename: Ashish
authors.initials: A
authors.lastname: Suri
authors.forename: P Sarat
authors.initials: PS
authors.lastname: Chandra
authors.forename: Shashank Sharad
authors.initials: SS
authors.lastname: Kale
authors.forename: Bhawani Shankar
authors.initials: BS
authors.lastname: Sharma
mesh_terms: D002426:Cavernous Sinus; D006801:Humans; D008577:Meningeal Neoplasms / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D019635:Neurosurgical Procedures / Q000379:methods; D012189:Retrospective Studies; D013100:Sphenoid Bone