Classical pterional compared to the extended skull base

J Clin Neurosci · Dec 2012

Classical pterional compared to the extended skull base approach for the removal of clinoidal meningiomas.

We reviewed a series of 46 consecutive, surgically treated patients with clinoidal meningioma to compare the classical pterional approach (32 patients) to an extended approach including extradural clinoidectomy and removal of the optic canal roof (14 patients). The tumor size and Al-Mefty type, the extension into the optic canal, the time to identification of the optic nerve and internal carotid artery, and the visual outcome were evaluated. Complete tumor resection was obtained in 81% of patients with the classic pterional approach compared to 93% of patients using an extended approach. The extended skull base approach should be used routinely in clinoidal meningiomas >2.5 cm in size, in ones of Al-Mefty type III, and in all patients with tumor extension into the optic canal.

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- G Mariniello, O de Divitiis, V Seneca, and F Maiuri.
- Department of Neurological Sciences, Neurosurgical Clinic, "Federico II" University School of Medicine, 5 Via S. Pansini, Naples 80131, Italy. giumarin@unina.it
- J Clin Neurosci. 2012 Dec 1; 19 (12): 1646-50.
AbstractWe reviewed a series of 46 consecutive, surgically treated patients with clinoidal meningioma to compare the classical pterional approach (32 patients) to an extended approach including extradural clinoidectomy and removal of the optic canal roof (14 patients). The tumor size and Al-Mefty type, the extension into the optic canal, the time to identification of the optic nerve and internal carotid artery, and the visual outcome were evaluated. Complete tumor resection was obtained in 81% of patients with the classic pterional approach compared to 93% of patients using an extended approach. The extended skull base approach should be used routinely in clinoidal meningiomas >2.5 cm in size, in ones of Al-Mefty type III, and in all patients with tumor extension into the optic canal.Copyright © 2012 Elsevier Ltd. All rights reserved.

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Classical pterional compared to the extended skull base approach for the removal of clinoidal meningiomas.

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