• da SilvaCarlos EduardoCEThe Center for Neurosurgery and Skull Base Surgery, Hospital Ernesto Dornelles, Porto Alegre, Brazil; Anatomy, Department of Basic Sciences of Health, Universidade Federal de Ciências da Saúde de Porto Alegre, UFCSPA, Porto Alegre,, Claudia Zanatta, Ana Clara Thibes, and Tamara Vidaletti.
• The Center for Neurosurgery and Skull Base Surgery, Hospital Ernesto Dornelles, Porto Alegre, Brazil; Anatomy, Department of Basic Sciences of Health, Universidade Federal de Ciências da Saúde de Porto Alegre, UFCSPA, Porto Alegre, Brazil. Electronic address: dasilvacebr@yahoo.com.br.
• World Neurosurg. 2022 Jul 1; 163: e635-e646.

BackgroundSphenoid wing meningiomas with cavernous sinus invasion (SWMCSI) are challenging tumors. The preservation of quality of life and cranial nerve function is one of the most relevant aspects of treating patients with SWMCSI.MethodsA retrospective study was conducted for surgery performed between 2008 and 2021, including 36 patients presenting with SWMCSI. The data from surgical intervention, Simpson grade of resection, tumor location, and morbimortality related to the surgery was reviewed. We examined the medical records, operative reports, radiologic examinations, and follow-up information.ResultsThe group comprised 29 women and 7 men with an average age of 61 years (range, 31-87 years). The mean follow-up period was 75 months (range, 1-170 months). Simpson grade I and II resections were obtained in 80% of cases. The meningiomas were World Health Organization (WHO) grade 1 in 94% of cases, WHO grade 2 in 3%, and WHO grade 3 in 3%. The overall mortality was 5.5%. Permanent cranial nerve deficits occurred in 8% of cases, transient cranial nerve deficits in 22%, cerebrospinal fistula in 16.5%, and hemiparesis in 2.7%. The recurrence/regrowth rate was 14% during the follow-up period. The Karnofsky Performance Status 100 and 90 was 92%.ConclusionsThe surgical treatment of symptomatic SWMCSI is an effective treatment modality with low morbimortality and good long-term control of the disease. Visual impairment is the most common abnormality, affecting preoperative and postoperative quality of life of patients with SWMCSI. Training in the microsurgical laboratory is essential for safe surgical approaches in this area.Copyright © 2022 Elsevier Inc. All rights reserved.

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