gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Medial sphenoid wing meningiomas – outcome of 49 cases

Meeting Abstract

  • M.T. Pedro - Abteilung für Neurochirurgie der Universität Ulm am BKH Günzburg
  • A. Jauss - Abteilung für Neurochirurgie der Universität Ulm am BKH Günzburg
  • C.P.G. Heinen - Abteilung für Neurochirurgie der Universität Ulm am BKH Günzburg
  • C.R. Wirtz - Abteilung für Neurochirurgie der Universität Ulm am BKH Günzburg
  • G. Antoniadis - Abteilung für Neurochirurgie der Universität Ulm am BKH Günzburg
  • J. Oberhoffer - Abteilung für Neurochirurgie der Universität Ulm am BKH Günzburg

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocSA.03.07

DOI: 10.3205/12dgnc327, URN: urn:nbn:de:0183-12dgnc3271

Published: June 4, 2012

© 2012 Pedro et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: Due to its localization the resection of medial sphenoid wing meningiomas is challenging. Frequently, patients present with severe neurological deficits due to cranial nerve and vessel involvement. One of the main goals is preserving function. We hereby present our experience.

Methods: We report 49 cases operated on during January 2000 until June 2011. We retrospectively analysed presenting symptoms, intra-operative complications and patient's outcome with a mean observation period of 2 years (3 months–11 years).

Results: Of 49 patients 37 were female and 12 male with a mean age of 54 years (23 years–74 years). In 14/49 only subtotal resection could be performed. 6/49 patients displayed no neurological deficit preoperatively, of which 5 remained asymptomatic after surgery. In 25/49 patients suffered from visual problems e.g. ptosis, diplopia or visual field defect, 10/49 presented with seizures, 8/49 with dizziness and 4/49 showed hypopituitarism. One patient showed a hemiparesis on admission. Postoperatively, in 10/49 a new palsy of the oculomotor nerve was found. Visual field deficits increased in 2 cases, 3 patients even were completely blind. 3 developed a new palsy of the abducens nerve, 3 patients showed brain edema needing decompression. In 5 transient hemiparesis was detected whereas 3 patients showed new seizures, 6 displayed a transient aphasia. One patient died during the first 24 h after surgery. During the mean observation of 2 years most of the neurological symptoms improved, especially the aphasia and the hemiparesis, whereas visual function usually did not. Generally, patients younger than 40 years seemed to have better outcome.

Conclusions: The resection of medial sphenoid wing meningioma has a high rate of surgical complications, especially concerning cranial nerve palsy and vascular problems. Therefore, meticulous preoperative planning and intraoperative monitoring is crucial when approaching this tumor entity.