Discussion Microsurgical Treatment O F The Medial Sphenoid Ridge Meningioma

Objective To analysis the clinical features of medial sphenoid ridge meningioma explore neurosurgery surgery treatment strategies and results, summarize clinical experience and surgical techniques designed to improve patient prognosis and reduce the incidence of postoperative complications and results.Methods From October 2010 to October 2014 in the Provincial Hospital Affiliated to Anhui Medical University Clinical Neurosurgery performance by significantly through micro‐neurosurgical treatment of 46 cases of medial sphenoid ridge meningioma, comprehensive and detailed assessment of radiological data, intraoperative before treatment, the choice of surgical approach, the effect of surgery, postoperative treatment, complications and prognosis in patients with follow‐up data were retrospectively analyzed. In patients with preoperative imaging data suggest that tumor diameter ≥5cm digitizing score, score relatively low degree of correlation with tumor resection. According to the Karnofsky Performance Scale of all patients in this group were followed up for 3‐4 years.Results The group of male patients 19 cases(41.30%), female patients 27 cases(58.70%), male to female ratio is about 1:1.421; mean age: 52.2 years(age 14‐73 years); performance headaches, dizziness and other symptoms of intracranial hypertension 34 cases(73.91%), with varying degrees of vision, vision disorders 31 cases(67.39%); the mean tumor diameter of 5.6cm(diameter 1.5cm‐9.2cm), whenthe tumor diameter before m SRM patients ≥5cm radiographic score greater than or equal 7:00, the higher the score, the more difficult the full extent of the cut, the higher the incidence of postoperative complications; By pterional or expand pterional microsurgical treatment 45 cases, approach the frontal in one case; total tumor resection 37 cases(80.44%), partially resection 9 cases(19.56%), which Simpson I grade 11 cases(23.91%), Simpson II grade 16 cases(34.78%), Simpson grade III 10 cases(21.75%), Simpson IV grade 9 cases(19.56%). Postoperative consciousness and hemiplegia 4 cases, 1 patient had a small amount of bleeding tumor cavity, brain edema associated with seizures, and the remaining three head CT showed no intracranial hematoma, but with significant brain edema around the lesion, neuropsychiatric symptoms three cases, Oculomotor nerve palsy after two cases. Routine postoperative pathology confirmed meningioma: 19 cases of epithelial type, 12 cases of transitional, six cases of skin cell type, fiber type five cases, two cases of atypical(both WHO II level), one case of vascular tumor type, mixed one case. According to the Karnofsky Performance Scale in this group of patients ‐ 4 year follow‐up of 3 months, with an average follow‐up of 26 months. KPS3 months and six months of 100 points, 90 points, 80 points, 70 points, 60 points, 50 points, 40 points, 30 points, respectively 3,6,10,6,9,7,4,1and number 5, 10,15,9,4,2,1 people, all of the patient’s condition is getting better or stable, no recurrence, death. Residual or surgical pathology suggestive WHOⅡ grade eleven cases postoperative patients with fractionated stereotactic radiotherapy, results were satisfactory.Conclusion Microsurgical sphenoid ridge meningioma resection is the most effective method of treatment, a detailed and comprehensive preoperative evaluation, surgical timely processing of individualized treatment strategies, a solid knowledge of the anatomy of the skull base, skilled surgical techniques, postoperative complications, postoperative discretion fractionated stereotacticradiotherapy is a key factor to improve medial sphenoid ridge meningioma microsurgery treatment, prognosis, and in the prevention of recurrence.