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Journal of Neurosurgical Sciences 1999 June;43(2):107-14

Copyright © 1999 EDIZIONI MINERVA MEDICA

lingua: Inglese

Basal meningiomas. A retrospective study of 139 surgical cases

Paterniti S., Fiore P., Levita A., La Camera A., Cambria S.

Institute of Neurological and Neurosurgical Sciences, 2nd Division of Neurosurgery, University Medical School, Messina, Italy


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Background. Basal menin­gio­mas rep­re­sent a sig­nif­i­cant group of intra­cra­ni­al ­tumours. Their sur­gi­cal treat­ment ­presents still today sev­er­al dif­fi­cul­ties since these ­tumours, as it is well known, may ­involve crit­i­cal neurovas­cu­lar struc­tures.
Methods. This is a ret­ro­spec­tive study of 139 con­sec­u­tive cases of basal menin­gio­ma oper­at­ed on in our insti­tu­tion dur­ing the last two ­decades. Meningiomas loca­tion: olfac­to­ry ­groove 20 cases; supra­sel­lar ­region 22; ante­ri­or cra­ni­al fossa 6; sphe­noid wing 37; cer­e­bel­lo­pon­tine angle/cli­vus 21; ten­tor­i­um 26. In most cases the menin­gio­ma was larg­er than 5 cm. The ­tumour was com­plete­ly ­removed (grade I-II of Simpson clas­sifi­ca­tion) in 111 cases (79.9%). The ­authors dwell upon some clin­i­cal and sur­gi­cal ­aspects of pre­vail­ing ­groups (olfac­to­ry, supra­sel­lar, sphe­noid­al, pet­ro­cli­val and ten­to­ri­al menin­gio­mas); regard­ing to oper­a­tive pro­ce­dures, the ­authors in par­tic­u­lar empha­sise the use­ful­ness of the pter­ion­al ­approach to ­remove olfac­to­ry ­groove menin­gio­mas and of the com­bined supra- and infra­ten­to­ri­al ­approach, with pres­er­va­tion of trans­verse and sig­moid sinus­es, to ­remove pet­ro­cli­val menin­gio­mas.
Results. The sur­gery was fol­lowed by excel­lent or good ­results in 115 cases (82.7%): ­patients hav­ing a nor­mal life with a score 80-100 of Karnofsky scale; poor out­come ­occurred in 5.8% of cases, post­op­er­a­tive­ly died 16 ­patients (mor­tal­ity rate 11.5%). Tumour recur­rence ­occurred in 7 cases.
Conclusions. Based on their expe­ri­ence and on anal­y­sis of the ­reviewed lit­er­a­ture, the ­authors con­clude that advanc­es in micro­sur­gi­cal tech­niques and in neu­ro­ra­dio­log­i­cal imag­ing have rad­i­cal­ly ­improved the out­come so that today basal menin­gio­mas can be suc­cess­ful­ly treat­ed in most cases.

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