Analysis On Clinical Features And Prognosis Of Sagittal Parameningeal Meningioma

ObjectiveTo explore and analyze the tumor characteristics and prognosis of patients with different clinical types of sagittal parameningeal meningioma.MethodsThis retrospective analysis of the clinical medical records of 68 patients with parasagittal meningioma admitted to the Department of Neurosurgery at Qilu Hospital of Shandong University from January 2012 to December 2019.Based on the preoperative imaging findings,the different degrees of meningioma invasion of the superior sagittal sinus can be divided into three different clinical types:mild occlusion type,moderate occlusion type and severe occlusion type.The general data,tumor characteristics,clinical manifestations,pathological features,surgical conditions and postoperative follow-up results of each patient were summarized.To analyze the relationship between tumor characteristics and prognosis of patients with different clinical types of sagittal parameningeal meningioma.ResultsIn this study,68 patients with sagittal sinus meningioma were hospitalized between 28 and 78 years of age,with an average age of 55 years.The course of disease ranges from 3 days to 20 years,with an average of 28 months.Among them,there were 26 males and 42 females,and the ratio of male to female was 1:1.6.After microsurgical treatment,58 cases had complete tumor resection,with a total resection rate of 81.6%.In the postoperative convalescence,66 cases were relieved of preoperative symptoms,accounting for 92.9%.Telephone follow-up found that 14 patients had permanent neurological dysfunction after the operation,accounting for 23.9%.Recurrence/progression was found in 3 patients with a recurrence rate of 4.0%.There were 3 deaths,with a mortality rate of 4.4%,and 55 cases(80.9%)with improved KPS score after treatment.In terms of pathological results,there were 61 cases of WHO ?,with a benign rate of 89.7%.There were 7 cases of WHO ?,accounting for 10.3%.Clinically,there were 24 cases of mild occlusion,25 cases of moderate occlusion and 19 cases of severe occlusion.The diameter of mildly occluded tumors was 3.55±1.29cm,the average diameter of moderately occluded tumors was 3.87±1.34cm,and the average diameter of severely occluded tumors was 5.43±1.94cm.There was a statistically significant difference in tumor size(P=0.001),with severe occlusion being relatively large.The total resection rate of tumor was statistically different(P=0.025).The total resection rate of mild occlusion(95.8%)and moderate occlusion(80.0%)was relatively higher,while the total resection rate of severe occlusion(63.1%)was relatively lower.Regarding the relationship between different classifications and lateral differentiation,24 cases of mild occlusion type were all unilateral growth,22 cases of moderate occlusion type were unilateral,and 3 cases of breakthrough unilateral angle of sagittal sinus invades the falx and contralateral Angle to the sagittal sinus grow on both sides,type heavy occlusion in 8 cases limited to unilateral growth,11 cases were bilateral growth,tumors on the side don't statistically significant(P=0.001),and severe occlusion model involving both sides more common.There was a statistical difference in the incidence of increased intracranial pressure(P=0.029)among the three clinical subtypes of paranasal meningiomas,with the highest incidence of severe occlusion.There was a statistically significant difference in tumor involvement in the sagittal sinus(P=0.020)severe occlusion type had the highest incidence in the anterior 1/3 sagittal sinus.ConclusionThe present study shows that the overall therapeutic effect of superior sagittal parietal meningioma is satisfactory.The clinical classification of superior sagittal paranasal meningioma provides an important reference for preoperative evaluation and prognosis of patients.Compared with the other two clinical types,patients with severe occlusion had larger tumor diameter,higher preoperative symptoms of cranial hypertension and bilateral sagittal sinus Angle involvement,and lower total resection rate.The application of microsurgical treatment,under the premise of fully protecting the reflux vein and sagittal sinus,combined with postoperative radiotherapy and other auxiliary treatment measures,can reduce the recurrence rate of patients and improve their postoperative quality of life.