Microsugical Operraticve Treatment To Meningiomas Of The Anterior Cranial Fossa Floor (32 Cases Report)

Meningiomas of the anterior crania1 fossa floor count for 12 to 28% of all intracranial meningionmas. The meningiomas are difficult to operate on because of their proximity to the optic nerve and tracts, the carotid arteries, and the anterior cerebral arteries,and their perforating branches.So it is hard to completely remove, high mortality rate, disabled rate. We should to choose surgical approaches.Objective: To conclude the anatomic characters of the meningiomas of the anterior crania1 fossa floor.To seek classification method for the meningiomas of the anterior crania1 fossa floor and how to choose surgical approaches. In order to enhance the total resetions rates, lower the mortality and disability rates. Methods:Review the 32 cases of meningiomas of the anterior crania1 fossa floor from Feb. 2007 to Feb. 2010 in our department and analyze their epidemiology, clinical symptoms, neuroimaging features, surgical approaches and curative effects, All the 32 cases were operated on using microsurgical techniques under general anesthesia.Results: We have 13 cases with Simpson I grade resection, 18 cases with II grade resection, 1 caseswith III grade resection. No case died and 4 cases appeared surgical complications. We have 26 cases follwed up for 4 to 48 months and 25 patients are self-care without recurring.Conclusion: Meningiomas of the anterior crania1 fossa floor may arise from the cribriform plate, orbital roof,planum sphenoidale, anterior clinoid process, and tuberculum. Patients should take ophthalmological and endocrinological evaluation. MRI should be used in all cases to supply additional information. MRI can define the relationship of the tumour with the optic chiasma, hypothalamus, and vascular structures.Different surgical approaches (bifrontal, pterional and transsphenoidal approach) are chosen to treat these meningiomas of the anterior crania1 fossa floor. The neuroendoscopic treatment have been used in microneurosurgical method more and more, which can obtain better exposure to remove tumours.Skull base reconstruction can prevent rhinorrhea, lower the intracranial infection rate.A variety of surgical approaches are used for meningiomas of the anterior crania1 fossa floor. An approach tailored to the tumor's size allows excellent outcome.