Evaluation of Outcomes and Complications of Sphenoid Wing Meningiomas in Tertiary Care Hospital of KPK

Sphenoid wing meningioma

Authors

  • Aafaq Ahmad Qarnain Neurosurgery resident
  • Mumtaz Ali
  • Akramullah
  • Sajid Khan
  • Zubair Bashir

DOI:

https://doi.org/10.36552/pjns.v28i1.909

Abstract

Objective:  The objective of this study is to evaluate the outcomes and complications associated with pterional craniotomy and extended pterional craniotomy for the resection of Sphenoid Wing Meningiomas.

Material and Methods:  A prospective study was conducted on 34 patients at the Neurosurgery department, Prime Teaching Hospital, Pakistan, and Ali Institute of Neurosciences. We examined 34 recently diagnosed cases of sphenoid wing meningiomas, selected through a total enumerative sampling method. Diagnosis of these meningiomas was confirmed by comprehensive neurological assessment and imaging studies. Various surgical techniques, such as Pterional and Extended Pterional approaches, were employed in the procedures. Assessment of clinical outcomes and complications was conducted during follow-up evaluations. A total of 34 patients diagnosed with sphenoid wing meningiomas were covered as the study’s target population. All patients met certain criteria to be included in the study.

Results:  25 (73.6%) of the total number of patients were females and 9 (26.4%) were males. The mean age at diagnosis was 47 ± 5 years. Presenting symptoms included headache, seizures, visual loss, motor deficit, and cognitive decline. Surgical techniques used in tumor resection were pterional craniotomy and extended pterional craniotomy. Post-operative evaluation after follow-up studies showed that the symptoms reversed, including a reduction in headache, vision restoration, seizure control, and motor and cognitive function improvement.

Conclusion:  Pterional approach and extended Pterional approaches related to SWM removal are satisfactory rates of an acceptable and safe surgical treatment with satisfactory results concerning the total resection rate and related clinical improvement.

References

REFERENCES

Balasa. (n.d.). Surgical Strategies and Clinical Outcome of Large to Giant Sphenoid Wing Meningiomas: A Case Series Study. Retrieved from google scholar: https://www.mdpi.com/2076-3425/10/12/957

AL-Azhar. (n.d.). Surgical management of sphenoid ridge meningioma en plaque (...: Al-Azhar Assiut Medical Journal. Retrieved from google scholar: https://journals.lww.com/aamj/Fulltext/2020/18030/Surgical_management_of_sphenoid_ridge_meningioma.11.aspx

Hadanny. (n.d.). The Outcome of Intracranial Meningioma Surgery in Octogenarians: Matched Cohort Study. Retrieved from google scholar: https://www.sciencedirect.com/science/article/pii/S187887502032009X

Wiemels J, Wrensch M, Claus EB. Epidemiology and etiology of meningioma. J Neurooncol. 2010 Sep; 99(3):307-14. doi: 10.1007/s11060-010-0386-3. Epub 2010 Sep 7. PMID: 20821343; PMCID: PMC2945461.

Korhonen K, Salminen T, Raitanen J, Auvinen A, Isola J, Haapasalo H. Female predominance in meningiomas cannot be explained by differences in progesterone, estrogen, or androgen receptor expression. J Neurooncol. 2006 Oct; 80(1):1-7. doi: 10.1007/s11060-006-9146-9. Epub 2006 May 13. PMID: 16703453.

Baldi I, Engelhardt J, Bonnet C, Bauchet L, Berteaud E, Grüber A, Loiseau H. Epidemiology of meningiomas. Neurochirurgie. 2018 Mar; 64(1):5-14. doi: 10.1016/j.neuchi.2014.05.006. Epub 2014 Sep 22. PMID: 25249493.

Lee YS, Lee YS. Molecular characteristics of meningiomas. J Pathol Transl Med. 2020 Jan; 54(1):45-63. doi: 10.4132/jptm.2019.11.05. Epub 2020 Jan 15. PMID: 31964111; PMCID: PMC6986967.

Aizer AA, Abedalthagafi M, Bi WL, Horvath MC, Arvold ND, Al-Mefty O, Lee EQ, Nayak L, Rinne ML, Norden AD, Reardon DA, Wen PY, Ligon KL, Ligon AH, Beroukhim R, Dunn IF, Santagata S, Alexander BM. A prognostic cytogenetic scoring system to guide the adjuvant management of patients with atypical meningioma. Neuro Oncol. 2016 Feb; 18(2):269-74. doi: 10.1093/neuonc/nov177. Epub 2015 Aug 30. PMID: 26323607; PMCID: PMC4724184.

Nassiri F, Mamatjan Y, Suppiah S, Badhiwala JH, Mansouri S, Karimi S, Saarela O, Poisson L, Gepfner-Tuma I, Schittenhelm J, Ng HK, Noushmehr H, Harter P, Baumgarten P, Weller M, Preusser M, Herold-Mende C, Tatagiba M, Tabatabai G, Sahm F, von Deimling A; International Consortium on Meningiomas; Zadeh G, Aldape KD. DNA methylation profiling to predict recurrence risk in meningioma: development and validation of a nomogram to optimize clinical management. Neuro Oncol. 2019 Jul 11; 21(7):901-910. doi: 10.1093/neuonc/noz061. PMID: 31158293; PMCID: PMC6620635.

Chotai S, Schwartz TH. The Simpson Grading: Is It Still Valid? Cancers (Basel). 2022 Apr 15; 14(8):2007. doi: 10.3390/cancers14082007. PMID: 35454912; PMCID: PMC9031418.

Magill. (n.d.). Chapter 4 - Sphenoid wing meningiomas. Retrieved from google scholar: https://www.sciencedirect.com/science/article/pii/B9780128221983000264

Güdük. (n.d.). Sphenoid Wing Meningiomas: Surgical Outcomes in a Series of 141 Cases and Proposal of a Scoring System Predicting Extent of Resection. Retrieved from google scholar: https://www.sciencedirect.com/science/article/pii/S1878875019300452

Verma. (n.d.). Medial sphenoid wing meningiomas: Experience with microsurgical resection over 5 years and a review of literature. Retrieved from google scholar: https://www.neurologyindia.com/article.asp?issn=0028-3886;year=2016;volume=64;issue=3;spage=465;epage=475;aulast=Verma;type=0

Park. (n.d.). Comparative Analysis of Endoscopic Transorbital Approach and Extended Mini-Pterional Approach for Sphenoid Wing Meningiomas with Osseous Involvement: Preliminary Surgical Results. Retrieved from google scholar: https://www.sciencedirect.com/science/article/pii/S1878875020301339

Masalha. (n.d.). Management of Medial Sphenoid Wing Meningioma Involving the Cavernous Sinus: A Single-Center Series of 105 Cases. Retrieved from google scholar: https://www.mdpi.com/2072-6694/14/9/2201

Chen. (n.d.). The Extended Pterional Approach Allows Satisfactory Results for the Resection of Huge Medial Sphenoid Ridge Meningioma. Retrieved from google scholar: https://www.sciencedirect.com/science/article/pii/S1878875023006897

Park HH, Yoo J, Yun IS, Hong CK. Comparative Analysis of Endoscopic Transorbital Approach and Extended Mini-Pterional Approach for Sphenoid Wing Meningiomas with Osseous Involvement: Preliminary Surgical Results. World Neurosurg. 2020 Jul; 139:e1-e12. doi: 10.1016/j.wneu.2020.01.115. Epub 2020 Jan 28. PMID: 32001400.

Nassar. (n.d.). Recurrence rate of sphenoid wing meningiomas and role of peritumoural brain edema: a single center retrospective study. Retrieved from google scholar: http://theunj.org/article/view/242064

Goncalves. (n.d.). Transorbital Endoscopic Surgery for Sphenoid Wing Meningioma: Long-Term Outcomes and Surgical Technique. Retrieved from google scholar: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1713854

Abdelsalam, E. a. (n.d.). Surgical Management of Middle Cranial Fossa Meningiomas: Experience of 35 Cases. Retrieved from google scholar: https://mjcu.journals.ekb.eg/article_125478.html

Chen. (n.d.). The Extended Pterional Approach Allows Satisfactory Results for the Resection of Huge Medial Sphenoid Ridge Meningioma. Retrieved from google scholar: https://www.sciencedirect.com/science/article/pii/S1878875023006897

Mirone G, Chibbaro S, Schiabello L, Tola S, George B. En Plaque Sphenoid Wing Meningiomas: Recurrence factors and surgical strategy in a series of 71 patients. Neurosurgery. 2009; 65 Suppl 6:S100–8.

Ringel F, Cedzich C, Schramm J. Microsurgical technique and result of a series of 63 spheno-orbital meningiomas. Neurosurgery. 2007; 60 Suppl 2:S214–22.

Simas NM, Farias JP. Sphenoid Wing en plaque meningiomas: Surgical results and recurrence rates. Surg Neurol Int. 2013 Jul 9; 4:86. doi: 10.4103/2152-7806.114796. PMID: 23956929; PMCID: PMC3740617.

Seyed-Nezhad M, Ahmadi B, Akbari-Sari A. Factors affecting the successful implementation of the referral system: A scoping review. J Family Med Prim Care. 2021 Dec; 10(12):4364-4375. doi: 10.4103/jfmpc.jfmpc_514_21. Epub 2021 Dec 27. PMID: 35280649; PMCID: PMC8884299.

Badry. (n.d.). Outcome of medial sphenoidal wing meningioma surgery. Retrieved from google scholar: https://journals.lapub.co.uk/index.php/roneurosurgery/article/view/1061

Séguin JR. The frontal lobe and aggression. Eur J Dev Psychol. 2009 Jan 5; 6(1):100-119. doi: 10.1080/17405620701669871. PMID: 24976846; PMCID: PMC4072650.

Lynch JC, Pereira CE, Gonçalves M, Zanon N. Extended Pterional Approach for Medial Sphenoid Wing Meningioma: A Series of 47 Patients. J Neurol Surg B Skull Base. 2020 Apr; 81(2):107-113. doi: 10.1055/s-0039-1677728. Epub 2019 Feb 21. PMID: 32206527; PMCID: PMC7082174.

Sughrue ME, Kane AJ, Shangari G, Rutkowski MJ, McDermott MW, Berger MS, Parsa AT. The relevance of Simpson Grade I and II resection in modern neurosurgical treatment of World Health Organization Grade I meningiomas. J Neurosurg. 2010 Nov; 113(5):1029-35. doi: 10.3171/2010.3.JNS091971. Epub 2010 Apr 9. PMID: 20380529.

Chaichana KL, Jackson C, Patel A, Miller NR, Subramanian P, Lim M, Gallia G, Olivi A, Weingart J, Brem H, Quiñones-Hinojosa A. Predictors of visual outcome following surgical resection of medial sphenoid wing meningiomas. J Neurol Surg B Skull Base. 2012 Oct; 73(5):321-6. doi: 10.1055/s-0032-1321510. PMID: 24083123; PMCID: PMC3578636.

Valencia-Ramos C, Arroyo Del Castillo JG, Aragon JF, Eguiluz-Mendez AG, Guinto-Nishimura GY, Sangrador-Deitos MV, Gómez Amador JL. Prognostic Factors in the Surgery of Clinoidal Meningiomas. Cureus. 2023 Jun 8; 15(6):e40122. doi: 10.7759/cureus.40122. PMID: 37435264; PMCID: PMC10332639.

Baumgarten P, Sarlak M, Monden D, Spyrantis A, Bernatz S, Gessler F, Dubinski D, Hattingen E, Marquardt G, Strzelczyk A, Rosenow F, Harter PN, Seifert V, Freiman TM. Early and Late Postoperative Seizures in Meningioma Patients and Prediction by a Recent Scoring System. Cancers (Basel). 2021 Jan 25; 13(3):450. doi: 10.3390/cancers13030450. PMID: 33504023; PMCID: PMC7865990.

Gondar R, Patet G, Schaller K, Meling TR. Meningiomas and Cognitive Impairment after Treatment: A Systematic and Narrative Review. Cancers (Basel). 2021 Apr 13; 13(8):1846. doi: 10.3390/cancers13081846. PMID: 33924372; PMCID: PMC8070481.

Park GO, Park HH, Yoo J, Hong CK, Oh J. Surgical Outcomes of Sphenoid Wing Meningioma with Periorbital Invasion. J Korean Neurosurg Soc. 2022 May; 65(3):449-456. doi: 10.3340/jkns.2021.0109. Epub 2022 Mar 3. PMID: 35236015; PMCID: PMC9082120.

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Published

2024-03-09

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