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J Neurol Surg B Skull Base 2012; 73(05): 321-326
DOI: 10.1055/s-0032-1321510
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Predictors of Visual Outcome Following Surgical Resection of Medial Sphenoid Wing Meningiomas

Kaisorn L. Chaichana
1   Department of Neurosurgery, Brain Tumor Surgery Program, Johns Hopkins Hospital, Baltimore, Maryland, United States
,
Christopher Jackson
1   Department of Neurosurgery, Brain Tumor Surgery Program, Johns Hopkins Hospital, Baltimore, Maryland, United States
,
Amar Patel
1   Department of Neurosurgery, Brain Tumor Surgery Program, Johns Hopkins Hospital, Baltimore, Maryland, United States
,
Neil R. Miller
1   Department of Neurosurgery, Brain Tumor Surgery Program, Johns Hopkins Hospital, Baltimore, Maryland, United States
,
Prem Subramanian
1   Department of Neurosurgery, Brain Tumor Surgery Program, Johns Hopkins Hospital, Baltimore, Maryland, United States
,
Michael Lim
1   Department of Neurosurgery, Brain Tumor Surgery Program, Johns Hopkins Hospital, Baltimore, Maryland, United States
,
Gary Gallia
1   Department of Neurosurgery, Brain Tumor Surgery Program, Johns Hopkins Hospital, Baltimore, Maryland, United States
,
Alessandro Olivi
1   Department of Neurosurgery, Brain Tumor Surgery Program, Johns Hopkins Hospital, Baltimore, Maryland, United States
,
Jon Weingart
1   Department of Neurosurgery, Brain Tumor Surgery Program, Johns Hopkins Hospital, Baltimore, Maryland, United States
,
Henry Brem
1   Department of Neurosurgery, Brain Tumor Surgery Program, Johns Hopkins Hospital, Baltimore, Maryland, United States
,
Alfredo Quiñones-Hinojosa
1   Department of Neurosurgery, Brain Tumor Surgery Program, Johns Hopkins Hospital, Baltimore, Maryland, United States
› Author Affiliations
Further Information

Publication History

13 December 2011

29 February 2012

Publication Date:
30 July 2012 (online)

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Abstract

Objective Medial sphenoid wing meningiomas (SWMs) are relatively common tumors that are associated with significant morbidity and mortality, primarily from their anatomic proximity to many critical neurological and vascular structures. A major complication is visual deterioration. This study aimed to identify predictors of visual outcome following medial SWM resection.

Design Retrospective, stepwise multivariate proportional hazards regression analysis.

Setting Johns Hopkins Hospital.

Participants All patients who underwent medial SWM resection from 1998 to 2009.

Main Outcome Measures Visual function.

Results Sixty-five medial SWM resections were performed. After multivariate proportional hazards regression analysis, preoperative visual decline (relative risk [RR] 95% confidence interval [CI]; 13.431 [2.601 to 46.077], p = 0.006), subtotal resection (RR [95% CI]; 3.717 [1.204 to 13.889], p = 0.02), and repeat surgery (RR [95% CI]; 5.681 [1.278 to 19.802], p = 0.03) were found to be independent predictors of visual decline at last follow-up. Tumor recurrence and postoperative radiation therapy trended toward, but did not reach statistical significance.

Conclusion These findings advocate for early and aggressive surgical intervention for patients with medial SWMs to maximize the likelihood of subsequent visual preservation. This may provide patients and physicians with prognostic information that may guide medical and surgical therapy for patients with medial SWMs.

Keywords

sphenoid wing - meningioma - vision loss - risk factors - outcomes
 

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