Microsurgical Treatment Of Sphenoid Ridge Meningioma

Objective： To summarize the experience in the microsurgical treatment ofsphenoid ridge meningioma to improve the therapeutic efficacy of sphenoid ridgemeningioma.Methods：52patients with SRM were treated with Microsurgical techniques fromFebruary2005to February2013in0ur department.Analysis the clinical data, imagingcharacteristics and surgical techniques of52patients retrospectively.Results：Meningiomas were confirmed with pathologically of52cases of SRMpatients after Microsurgical treatment.Pathological type of tumor was fibrous in12cases，endothelial in23,vascular in10and mixed cellular in7.With reference to the theSimpson classification method (Simpson), Simpson grade I resection was performed in10，Simpson grade II resection in23，Simpson grade III resection in15and Simpsongrade Ⅳresection in4.No patients died during operation.Among the patients withheadache and dizziness, the number of patients with less headache and dizzinessreached to23after surgery.The symptom of19patients disappeared,but new headacheand dizziness appear with one case.Among the patients with eye movement disorderbefore surgery,7cases were recovered to normal,19cases were improved and2caseshad no significant changes after surgery; Among the patients with vision loss beforesurgery,15cases were improved,8cases were recovered to normal eyesight,3caseshad no obvious changes and1case was newly found for vision loss after surgery;Among the patients with visual field defect before surgery,21cases were improved and3cases had no significant changes after surgery; Among the patients with ocularproptosis before surgery,4cases were improved and3cases had no significant changesafter surgery; The patients with hyposmia before surgery were all improved to someextent, the patients with anosmia were somewhat recovered after surgery, and thepatients with olfactory hallucination before surgery were recovered after surgery; Thepatients with frontal temporal bone swell before surgery had good shape after skull reconstruction and repair, without recurrence; Among the patients with epilepsy beforesurgery,9cases had recurrence after surgery and new recurrence of16cases, whichwere effectively controlled after active antiepileptic treatment; The patients withmemory impairment before surgery were all improved to different extent after surgery;Among the patients with hemiplegia before surgery,4cases were recovered to normalmuscle strength and6cases were improved after surgery; The patients with mentaldisorders before surgery were all improved to different extent; There were3cases withlow pituitary function and diabetes insipidus after surgery, which all returned to normalafter antidiuretic hormone and hormone replacement therapy, where1case hadintracranial infection, but improved and discharged from hospital after the positiveanti-infection treatment and symptomatic treatment.After1to3years of follow—up，norecurrence was found in patients who underwent Simpson grade I or II resection,2recurrences were detected in patients who underwent Simpson grade III resection and4recurrences were detected in patients who underwent Simpson grade IV resection.Conclusion： Detailed and thorough preoperative assessment, individualizedsurgical plan formulation and skilled surgical techniques can help to improve the theSRM treatment of results, to reduce the occurrence of complications.