J Neurol Surg B Skull Base 2012; 73(01): 076-083
DOI: 10.1055/s-0032-1304562
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Association of Morbidity with Extent of Resection and Cavernous Sinus Invasion in Sphenoid Wing Meningiomas[*]

Michael E. Ivan
1   Department of Neurological Surgery, University of California, San Francisco, California.
,
Jason S. Cheng
1   Department of Neurological Surgery, University of California, San Francisco, California.
,
Gurvinder Kaur
1   Department of Neurological Surgery, University of California, San Francisco, California.
,
Michael E. Sughrue
1   Department of Neurological Surgery, University of California, San Francisco, California.
,
Aaron Clark
1   Department of Neurological Surgery, University of California, San Francisco, California.
,
Ari J. Kane
1   Department of Neurological Surgery, University of California, San Francisco, California.
,
Derick Aranda
1   Department of Neurological Surgery, University of California, San Francisco, California.
,
Michael McDermott
1   Department of Neurological Surgery, University of California, San Francisco, California.
,
Igor J. Barani
1   Department of Neurological Surgery, University of California, San Francisco, California.
,
Andrew T. Parsa
1   Department of Neurological Surgery, University of California, San Francisco, California.
› Author Affiliations
Further Information

Publication History

01 July 2011

06 September 2011

Publication Date:
24 February 2012 (online)

Abstract

Sphenoid wing meningiomas (SWMs) typically are histologically benign, insidious lesions, but the propensity of these tumors for local invasion makes disease control very challenging. In this review, we assess whether the degree of resection and extent of cavernous sinus invasion affects morbidity, mortality, and recurrence in patients with SWM. A comprehensive search of the English-language literature was performed. Patients were stratified according to extent of resection and extent of cavernous sinus invasion, and tumor recurrence rate, morbidity, and mortality were analyzed. A total of 23 studies and 131 patients were included. Overall recurrence and surgical mortality rate were 11% and 2%, respectively (average follow-up = 65 months). Cranial nerve III palsy was significantly associated with incompletely versus completely resected SWMs (7 to 0%) as well as meningiomas with cavernous sinus invasion versus no sinus invasion (14 vs. 0%). No significant difference in tumor recurrence rate was noted between these groups. In conclusion, complete excision of SWMs is always recommended whenever possible, but surgeons should acknowledge that there is nonetheless a chance of recurrence and should weigh this against the risk of causing cranial nerve injuries.

* This article was originally Published online in Skull Base on December 1, 2011 (DOI:10.1055/s-0031-1296042)


 
  • References

  • 1 Aziz KM, Froelich SC, Cohen PL, Sanan A, Keller JT, van Loveren HR. The one-piece orbitozygomatic approach: the MacCarty burr hole and the inferior orbital fissure as keys to technique and application. Acta Neurochir (Wien) 2002; 144 (1) 15-24
  • 2 Pieper DR, Al-Mefty O, Hanada Y, Buechner D. Hyperostosis associated with meningioma of the cranial base: secondary changes or tumor invasion. Neurosurgery 1999; 44 (4) 742-746, discussion 746–747
  • 3 Cushing HEL. Meningiomas: Their classification, regional behavior, life history, and surgical end results. In: Thomas CC, ed Springfield: 1938: 311-319
  • 4 O’Sullivan MG, van Loveren HR, Tew Jr JM. The surgical resectability of meningiomas of the cavernous sinus. Neurosurgery 1997; 40 (2) 238-244, discussion 245–247
  • 5 al-Mefty O, Ayoubi S, Smith RR. Direct surgery of the cavernous sinus: patient selection. Acta Neurochir Suppl (Wien) 1991; 53: 117-121
  • 6 Al-Mefty O, Smith RR. Surgery of tumors invading the cavernous sinus. Surg Neurol 1988; 30 (5) 370-381
  • 7 Cusimano MD, Sekhar LN, Sen CN , et al. The results of surgery for benign tumors of the cavernous sinus. Neurosurgery 1995; 37 (1) 1-9, discussion 9–10
  • 8 el-Kalliny M, van Loveren H, Keller JT, Tew Jr JM. Tumors of the lateral wall of the cavernous sinus. J Neurosurg 1992; 77 (4) 508-514
  • 9 Bonnal J, Castermans A, Stevenaert A, Brotchi J, Vanwijck R. [Meningiomas of the anterior and middle portions of the skull base. Procedure to follow in bone invasions and extensions into the facial cavities]. Neurochirurgie 1972; 18 (5) 441-451
  • 10 Cook AW. Total removal of large global meningiomas at the medial aspect of the sphenoid ridge. Technical note. J Neurosurg 1971; 34 (1) 107-113
  • 11 Cophignon J, Lucena J, Clay C, Marchac D. Limits to radical treatment of spheno-orbital meningiomas. Acta Neurochir Suppl (Wien) 1979; 28 (2) 375-380
  • 12 Dolenc V. Microsurgical removal of large sphenoidal bone meningiomas. Acta Neurochir Suppl (Wien) 1979; 28 (2) 391-396
  • 13 Fischer G, Fischer C, Mansuy L. [Surgical prognosis of meningiomas of the sphenoidal ridge]. Neurochirurgie 1973; 19 (4) 323-346
  • 14 Guyot JF, Vouyouklakis D, Pertuiset B. [Meningiomas of the sphenoidal ridge: apropos of 50 cases]. Neurochirurgie 1967; 13 (5) 571-584
  • 15 Sughrue ME, Kane AJ, Shangari G , et al. The relevance of Simpson Grade I and II resection in modern neurosurgical treatment of World Health Organization Grade I meningiomas. J Neurosurg 2010; 113 (5) 1029-1035
  • 16 Baek JU, Cho YD, Yoo JC. An osteolytic meningioma en plaque of the sphenoid ridge. J Korean Neurosurg Soc 2008; 43 (1) 34-36
  • 17 Behari S, Giri PJ, Shukla D, Jain VK, Banerji D. Surgical strategies for giant medial sphenoid wing meningiomas: a new scoring system for predicting extent of resection. Acta Neurochir (Wien) 2008; 150 (9) 865-877, discussion 877
  • 18 Bonnal J, Thibaut A, Brotchi J, Born J. Invading meningiomas of the sphenoid ridge. J Neurosurg 1980; 53 (5) 587-599
  • 19 Charbel FT, Hyun H, Misra M, Gueyikian S, Mafee RF. Juxtaorbital en plaque meningiomas. Report of four cases and review of literature. Radiol Clin North Am 1999; 37 (1) 89-100, x
  • 20 Cheng CM, Chang CF, Ma HI, Chiang YH, McMenomey SO, Delashaw Jr JB. Modified orbitozygomatic craniotomy for large medial sphenoid wing meningiomas. J Clin Neurosci 2009; 16 (9) 1157-1160
  • 21 Graze K, Molitch ME, Post K. Chronic demeclocycline therapy in the syndrome of inappropriate ADH secretion due to brain tumor. J Neurosurg 1977; 47 (6) 933-936
  • 22 Kinugasa K, Yamada T, Ohmoto T, Taguchi K. Iatrogenic dissecting aneurysm of the internal carotid artery. Acta Neurochir (Wien) 1995; 137 (3-4) 226-231
  • 23 Langevin CJ, Hanasono MM, Riina HA, Stieg PE, Spinelli HM. Lateral transzygomatic approach to sphenoid wing meningiomas. Neurosurgery 2010; 67 (2, Suppl Operative) 377-384
  • 24 Loh JK, Hwang SL, Tsai KB, Kwan AL, Howng SL. Sphenoid ridge lymphoplasmacyte-rich meningioma. J Formos Med Assoc 2006; 105 (7) 594-598
  • 25 Mickey B, Close L, Schaefer S, Samson D. A combined frontotemporal and lateral infratemporal fossa approach to the skull base. J Neurosurg 1988; 68 (5) 678-683
  • 26 Nakase H, Ohnishi H, Matsuyama T, Morimoto T, Sakaki T. Two-stage skull base surgery for tumours extending to the sub- and epidural spaces. Acta Neurochir (Wien) 1998; 140 (9) 891-898
  • 27 Nishio S, Morioka T, Suzuki S, Hirano K, Fukui M. Secretory meningioma: clinicopathologic features of eight cases. J Clin Neurosci 2001; 8 (4) 335-339
  • 28 Ohaegbulam SC. Large sphenoid ridge meningioma in a child. Surg Neurol 1977; 7 (3) 143-144
  • 29 O’Reilly RA, Hamilton RD. Acquired hemophilia, meningioma, and diphenylhydantoin therapy. J Neurosurg 1980; 53 (5) 600-605
  • 30 Russell SM, Benjamin V. Medial sphenoid ridge meningiomas: classification, microsurgical anatomy, operative nuances, and long-term surgical outcome in 35 consecutive patients. Neurosurgery 2008; ; 62 (3) , Suppl (Suppl. 01) 38-50, discussion 50
  • 31 Shuangshoti S, Siriaungkul S, Suwanwela N. Primary meningioma intimately related to skull: case report and review of the literature. Surg Neurol 1994; 42 (6) 476-480
  • 32 Shuto T, Inomori S, Fujino H, Nagano H, Hasegawa N, Kakuta Y. Cyst formation following gamma knife surgery for intracranial meningioma. J Neurosurg 2005; 102 ( Suppl): 134-139
  • 33 Tomasello F, de Divitiis O, Angileri FF, Salpietro FM, d’Avella D. Large sphenocavernous meningiomas: is there still a role for the intradural approach via the pterional-transsylvian route?. Acta Neurochir (Wien) 2003; 145 (4) 273-282, discussion 282
  • 34 Ueno Y, Tanaka A, Nakayama Y. Transient neurological deficits simulating transient ischemic attacks in a patient with meningioma—case report. Neurol Med Chir (Tokyo) 1998; 38 (10) 661-665
  • 35 Watts P, Newsom R, McAllister J. Sphenoidal ridge meningioma masquerade: glaucoma with a sphenoidal ridge meningioma. Eye (Lond) 1996; 10 (Pt 5) 629-634
  • 36 Weber J, Gassel AM, Hoch A, Kilisek L, Spring A. Intraoperative management of cystic meningiomas. Neurosurg Rev 2003; 26 (1) 62-66
  • 37 Weisman PA. Meningioma of the sphenoid ridge. Palliative surgery for facial involvement. Panminerva Med 1969; 11 (3) 117-122
  • 38 Westendorff C, Kaminsky J, Ernemann U, Reinert S, Hoffmann J. Image-guided sphenoid wing meningioma resection and simultaneous computer-assisted cranio-orbital reconstruction: technical case report. Neurosurgery 2007; ; 60 (2) , Suppl (Suppl. 01) E173-E174, discussion E174
  • 39 Pompili A, Derome PJ, Visot A, Guiot G. Hyperostosing meningiomas of the sphenoid ridge—clinical features, surgical therapy, and long-term observations: review of 49 cases. Surg Neurol 1982; 17 (6) 411-416
  • 40 DeMonte F, Smith HK, al-Mefty O. Outcome of aggressive removal of cavernous sinus meningiomas. J Neurosurg 1994; 81 (2) 245-251
  • 41 Dolenc V. Direct microsurgical repair of intracavernous vascular lesions. J Neurosurg 1983; 58 (6) 824-831
  • 42 Lee JH, Jeun SS, Evans J, Kosmorsky G. Surgical management of clinoidal meningiomas. Neurosurgery 2001; 48 (5) 1012-1019, discussion 1019–1021