Sunday, December 16, 2012

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

December 2012
Publication year: 2012
Source:Journal of Clinical Neuroscience, Volume 19, Issue 12

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 >2.5cm in size, in ones of Al-Mefty type III, and in all patients with tumor extension into the optic canal.






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