gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

The preoperative assessment of optic canal extension of medial sphenoid wing meningiomas

Präoperative Beurteilung medialer Keilbeinflügelmeningeome bezüglich der Optikuskanal-Infiltration

Meeting Abstract

  • corresponding author F.H. Ebner - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • C. Ramina - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • M. Tatagiba - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • F. Roser - Klinik für Neurochirurgie, Universitätsklinikum Tübingen

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocSO.01.06

The electronic version of this article is the complete one and can be found online at:

Published: May 30, 2008

© 2008 Ebner et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: The preoperative assessment of medial sphenoid wing meningiomas concerning their involvement of the optic canal is still demanding. It is quite challenging to predict tumour extension into the optic foramen based on MRI. To evaluate this hypothetic discrepancy, we present a series of medial sphenoid wing meningiomas with intraoperative evidence of intracanalicular tumour extension not reflected by preoperative imaging.

Methods: From 2004-2007 400 meningiomas have been operated on at the Department of Neurosurgery. Fifty-eight medial sphenoid wing meningiomas were evaluated prospectively by computed tomography and MRI before the operation. In all patients the intraoperative video, a questionnaire from the surgeon and postoperative imaging were evaluated in respect to tumour infiltration and/or extension into the optic canal and extent of decompression.

Results: On the preoperative MRI, 38 patients did not show any tumour infiltration of the optic canal in coronal fat-suppressed MRI sequences. In 50% of these patients, the optic canal was nevertheless opened for decompression and intracanalicular tumour was found in 17/19 of these cases. None of the patients with an opened optic canal sustained visual loss or any morbidity due to the bony decompression.

Conclusions: Extension of medial sphenoid wing meningiomas into the optic canal is not sufficiently predictable by neuroimaging despite fat-suppression techniques. We therefore recommend meticulous inspection of the optic foramen and generous opening of the bony margins for decompression of the optic nerve.