Acta neurochirurgica
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Acta neurochirurgica · Sep 2008
Surgical strategies for giant medial sphenoid wing meningiomas: a new scoring system for predicting extent of resection.
Surgical management of giant medial sphenoid meningiomas (> or =5 cm in maximum dimension) is extremely challenging due to their intimate relationship with vital neural structures like the optic nerve, cranial nerves of the cavernous sinus and the cavernous internal carotid artery. Their surgical management is presented incorporating a radiological scoring system that predicts the grade of tumour excision. ⋯ A relatively conservative approach to these extensive lesions resulted in good outcome in a majority of our patients. Both the standard as well as skull base approaches may be utilized for successful removal of giant medial sphenoidal wing meningiomas. A preoperative radiological score of > or =7 predicts a greater degree of difficulty in achieving complete surgical extirpation.