Article
Surgery for sphenoid wing meningiomas in the elderly
Chirurgie der Keilbeinflügelmeningiome bei älteren Patienten
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Authors
Published: | April 23, 2004 |
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Outline
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Objective
Surgery for sphenoid wing meningiomas is difficult in all age groups, but there is still a dispute about whether to observe or operate on an elderly patient with a mildly symptomatic tumour in this location. We have tried to prove if age correlates with postoperative outcome in patients with sphenoid wing meningiomas.
Methods
Clinical charts of the patients including surgical records, discharge letters, histological records and imaging studies, as well as meticulously focused questionnaires of clinical outcome were reviewed. To match both groups for comparable variables, we excluded patients with recurrent, atypical or anaplastic tumours, incidental meningiomas or tumours < 2cm, as well as en plaque or intraosseous sphenoid wing meningiomas from the study.
Results
The “elderly” group consist of 17 patients older than 70 years (range 70-86). Mean Karnofsky-Index at presentation was 88 (60-100), with concomitant disease in all patients (mean 1.7). Perioperative morbidity was acceptably low, with a mean hospital stay of 21.2 days (11-56). The postoperative Karnofsky score was 75.7 (0-100) with patients improved in 23.5% and worsened in 35.3% of cases through surgery. The “young” group consist of 34 patients (mean age 56.8 years; range 29-69), with a pre-op Karnofsky score of 87 (70-100) and concomitant disease in 27 patients (mean of 2.1). Post-op Karnofsky score was 85.6 (40-100) with 29.4% of patients’ improved and 17.6% of patients worsened through operation.
Conclusions
Comparing both age groups for several parameters, we found that surgical outcome of sphenoid wing meningiomas is not related to the age of the patient. Elderly patients recovered from surgery or improved their neurological deficits with comparable morbidity. However careful pre-operative neuroanaesthesiological evaluation is necessary to avoid age and co-morbidity related complications.