BACKGROUND: Anterior clinoidal meningiomas (ACMs) are a subgroup of meningiomas accounting for less than 10% of supratentorial meningiomas. OBJECTIVE: To assess the reliability and safeness of the lateral supraorbital approach (LSO) to remove ACMs. METHODS: Between September 1997 and October 2009, a total of 73 ACM patients were operated on at the Department of Neurosurgery, Helsinki University Central Hospital, by the senior author (J.H.). We retrospectively analyzed the clinical data, radiological findings, surgical treatment, histology, and outcome of patients, and discuss the operative technique. RESULTS: Seventy-three patients were operated on by applying the LSO approach. Apparently complete removal was achieved in 57 patients (78%). Anterior clinoidectomy was performed in 21 cases. Preexisting visual deficit improved in 11 of 39 patients and worsened in 4; 3 had de novo visual deficit. At 3 months after discharge, 60 (82%) patients had a good recovery, 9 (12%) patients were moderately disabled, 1 presented with severe disability, and 3 (4%) patients died of surgery-related causes. Sixteen (22%) patients had residual tumors, 6 of which required reoperation. During the median follow-up of 36 months (range, 3-146), tumor recurred in 3 patients: 2 were followed-up and 1 was reoperated on. CONCLUSION: ACMs can be removed via the LSO approach with relatively low morbidity and mortality. Anterior clinoidectomy is required only in selected cases, and we prefer the intradural approach during the LSO approach. High-power coagulation should be avoided in proximity of the optic nerve.
BACKGROUND:Anterior clinoidal meningiomas (ACMs) are a subgroup of meningiomas accounting for less than 10% of supratentorial meningiomas. OBJECTIVE: To assess the reliability and safeness of the lateral supraorbital approach (LSO) to remove ACMs. METHODS: Between September 1997 and October 2009, a total of 73 ACM patients were operated on at the Department of Neurosurgery, Helsinki University Central Hospital, by the senior author (J.H.). We retrospectively analyzed the clinical data, radiological findings, surgical treatment, histology, and outcome of patients, and discuss the operative technique. RESULTS: Seventy-three patients were operated on by applying the LSO approach. Apparently complete removal was achieved in 57 patients (78%). Anterior clinoidectomy was performed in 21 cases. Preexisting visual deficit improved in 11 of 39 patients and worsened in 4; 3 had de novo visual deficit. At 3 months after discharge, 60 (82%) patients had a good recovery, 9 (12%) patients were moderately disabled, 1 presented with severe disability, and 3 (4%) patients died of surgery-related causes. Sixteen (22%) patients had residual tumors, 6 of which required reoperation. During the median follow-up of 36 months (range, 3-146), tumor recurred in 3 patients: 2 were followed-up and 1 was reoperated on. CONCLUSION: ACMs can be removed via the LSO approach with relatively low morbidity and mortality. Anterior clinoidectomy is required only in selected cases, and we prefer the intradural approach during the LSO approach. High-power coagulation should be avoided in proximity of the optic nerve.
Authors: YouYuan Bao; YouQing Yang; Lin Zhou; ShenHao Xie; Xiao Wu; Han Ding; Jie Wu; Limin Xiao; Le Yang; Bin Tang; Tao Hong Journal: Front Oncol Date: 2022-05-26 Impact factor: 5.738
Authors: Hun Ho Park; Kyoung Su Sung; Ju Hyung Moon; Eui Hyun Kim; Sun Ho Kim; Kyu-Sung Lee; Chang-Ki Hong; Jong Hee Chang Journal: Neurosurg Rev Date: 2019-08-03 Impact factor: 3.042
Authors: Messias Gonçalves Pacheco Junior; José Orlando de Melo Junior; Marcus André Acioly; Raíssa Mansilla Cabrera Rodrigues; Bruno Lima Pessôa; Rafael A Fernandes; José Alberto Landeiro Journal: Cureus Date: 2021-05-06