• Yuxuan Deng, Lanbing Yu, Yifan Lv, Xing Liu, Junsheng Chu, Zhixian Gao, Shuyu Hao, and Nan Ji.
• Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
• World Neurosurg. 2023 Jul 1; 175: e336e343e336-e343.

ObjectiveThe clinical features and surgical techniques related to patients undergoing resection of extracranial large primary intraosseous meningiomas are studied.MethodsThe clinical characteristics, treatment, and prognosis of 6 patients with primary intraosseous meningiomas larger than 5 cm in diameter were retrospectively reviewed in the 10th Neurosurgical Department of Beijing Tiantan Hospital, Capital Medical University.ResultsFive males and one female (18-57 years old) suffered from large primary intraosseous meningiomas. The main symptoms were headaches accompanied by head swelling. CT showed irregular thickening of the bone diploe with increased density and uneven surface. MRI showed partial bone destruction of the skull, local thickening of the internal and external plates, shell and palisade changes of the external cranial plate, and enhancement of the adjacent meninges. A horseshoe or coronary incision plus the "Mercedes-Benz" incision were chosen to expose the skull bone, and drilling was performed in the normal skull bone at the transition zone between abnormal and normal skull bone. After drilling, the sub flap dura was dissected, the hyperplastic skull was dissected with a milling cutter, and the residual tumor was then resected. A cranioplasty was performed 6 months to 1 year later.ConclusionsSurgical treatment and precise perioperative management can achieve a better prognosis for large intraosseous meningiomas.Copyright © 2023 Elsevier Inc. All rights reserved.

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