Verma Satish Kumar, Sinha Sumit, Sawarkar Dattaraj Parmanand, Singh Pankaj Kumar, Gupta Deepak, Agarwal Deepak, Satyarthee Gurudatta, Kumar Rajinder, Singh Manmohanjit, Suri Ashish, Chandra P Sarat, Kale Shashank Sharad, Sharma Bhawani Shankar
Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India.
Neurol India. 2016 May-Jun;64(3):465-75. doi: 10.4103/0028-3886.181548.
Medial sphenoid wing meningiomas are medially located tumors on the sphenoid wing with attachment over the anterior clinoid process. They represent a distinct entity. These medial sphenoid wing meningiomas present a more difficult problem for the neurosurgeons because in a majority of cases, they involve the anterior visual pathways and arteries of the anterior circulation and may invade the cavernous sinus (CS). Higher morbidity, mortality and recurrence rates have been observed in these tumors compared with meningiomas in other locations. The rate of recurrence for medial sphenoid wing meningiomas is reported as being one of the highest amongst intracranial meningiomas.
The authors retrospectively analyzed 78 consecutive patients with the diagnosis of medial sphenoid wing meningioma who were operated in our department from January 2008 to December 2012.
These patients, having a meningioma of the medial sphenoid ridge, were divided into two types depending on the involvement of CS. Diplopia, internal carotid artery encasement, and postoperative visual deterioration were more common in Type 2 tumors. Similarly, extent of resection and postoperative morbidity were greater in Type 2 patients.
CS invasion confers an added risk to the surgical morbidity and outcomes. However, with proper surgical techniques, optimum outcomes can be achieved and overall surgical results at our center are found to be comparable to that of the current literature.
蝶骨嵴内侧脑膜瘤是位于蝶骨嵴内侧的肿瘤，附着于前床突。它们是一种独特的实体。这些蝶骨嵴内侧脑膜瘤给神经外科医生带来了更棘手的问题，因为在大多数情况下，它们累及前部视觉通路和前循环动脉，并且可能侵犯海绵窦（CS）。与其他部位的脑膜瘤相比，这些肿瘤的发病率、死亡率和复发率更高。据报道，蝶骨嵴内侧脑膜瘤的复发率是颅内脑膜瘤中最高的之一。
作者回顾性分析了2008年1月至2012年12月在本科室接受手术的78例连续诊断为蝶骨嵴内侧脑膜瘤患者。
这些患有蝶骨嵴内侧脑膜瘤的患者根据海绵窦受累情况分为两种类型。复视、颈内动脉包绕和术后视力恶化在2型肿瘤中更常见。同样，2型患者的切除范围和术后发病率更高。
海绵窦侵犯会增加手术发病率和影响手术结果的风险。然而，采用适当的手术技术，可以取得最佳结果，并且我们中心的总体手术结果与当前文献相当。
