211376 Results and complications of sphenocavernous meningiomas with special reference to postoperative ptosis

/Hao Shuyu(郝淑煜，Dept Neurosurg，Beijing Tiantan Hosp，Cap Med Univ，Beijing 100050)…∥Chin J Neurosurg.-2011，27(1).-18 ～22

ObjectiveTo study the surgical results and complications for sphenocavernous(SC)meningioma patients with special reference to postoperative ptosis.Methods49 consecutive cases of SC meningiomas operated between April 1993 and Dec 2008 in our department were reviewed.All the probable risk factors related to postoperative ptosis were studied with Logistic regression analysis.ResultsThere were 38 female and 11 male patients(mean age 52.4 years，range 31 ～ 74 years).The mean duration of symptoms was 20.9 months(ranging from 1 week to 108 months).Cranial nerves palsy was the most common presenting symptoms.The mean maximal diameter of tumor on MRI was 5.09 cm.Frontotemporal approach was performed in 30 cases，frontotemporal zygomatic approach in 14 cases and frontotemporal orbitozygomatic osteotomy approach in 5 cases.Subtotal resection was achieved in 52%patients.The surgical mortality was 2% .Follow-up data were available for 39 patients，with a mean follow-up of 73.7 months.Four patients died during follow-up period.Of the 35 living patients，22 lived a normal life.Multi-factors that might influence ptosis after operation included the grading of cavernous extension，pre-operation KPS and the history of surgery for tumors.ConclusionComplete and safe resection of SC meningioma is difficult.Our experience suggests that the most common complication after SC meningioma surgery is ocular CN dysfunction.The factors relative to postoperative ptosis include the extension to cavernous sinus，preoperation KPS and history of surgery for meningioma.Gamma knife radiosurgery could be considered as an adjuvant therapy only for recurrent tumors during follow-up period.11 refs，2 figs.