The Classification And Microsurgical Treatment Of Sphenoid Wing Meningioma

Objective : To make classification to sphenoid wing meningioma(SWM) by it's neuro-imaging and obsevation during surgical operation, and explore the preoperative valuation and micro-neurosurgical method of each type;Methods:Since 2002, 27 patients with sphenoid wing meningioma have been admitted to our department.All the patients received surgical management through pterional approach or modified pterional approach. A retrospective study was peformed on their clinical datas.Result:Of 27 cases of SWM,16 were lateral SWM(59.3%),all of which received totally resection (Simpson G-â… ,8 cases;Simpson G-â…¡,8 cases);11 were medial SWM(40.7%),of which 4 were totally resected(Simpson G-â…¡,1 cases; Simpson G-â…¢,3 cases),6 were subtotally resected(Simpson G-â…£) because of the close attachment to neurovascular structures,1 was partly resected(Simpson G-â…¤) thanks to the difficulty to control bleeding during the operation.All the patients underwent microsurgery without major incident except one who was given up and died.Conclusion : Cushing three-type classification of SWM can be simplified to two-type that is lateral and medial SWM,which is more practical and consistent with clinical findings. It is a detailed preoperative treatment plan,experienced microneurosurgery operation,skilled dissection nearby SWM ,the consciousness of neuro-function protecting and a comprehensive treatment that can make a precise tumor resection without major incident and a relatively good outcome.