open access

Vol 44, No 5 (2010)
ARTYKUŁ ORYGINALNY
Submitted: 2010-02-12
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Medial sphenoid ridge meningiomas: early and long-term results of surgical removal using the fronto-temporo-orbito-zygomatic approach

Piotr Ładziński, Henryk Majchrzak, Wojciech Kaspera, Krzysztof Majchrzak, Michał Tymowski, Piotr Adamczyk
DOI: 10.1016/S0028-3843(14)60137-7
·
Neurol Neurochir Pol 2010;44(5):464-474.

open access

Vol 44, No 5 (2010)
ARTYKUŁ ORYGINALNY
Submitted: 2010-02-12

Abstract

Background and purpose

The fronto-temporo-orbito-zygomatic approach (FTOZA) is an alternative to the pterional approach in surgical resection of meningiomas of the medial part of the lesser wing of the sphenoid bone. The purpose of this study is to present our results of treatment of these meningiomas using the FTOZA.

Material and methods

Thirty patients (19 women, 11 men) with a central skull base tumour were included in the study. The neurological status of the patients was assessed before and after surgery as well as at the conclusion of treatment. The approximate volume of the operated tumour, its relation to large blood vessels, cranial nerves and brainstem, as well as consistency and vascularisation were assessed.

Results

The symptom duration ranged from 1 to 36 months (median: 6 months). Impaired visual acuity was the predominant symptom in 27.5% of patients. Less frequent symptoms included paresis/paralysis of the third cranial nerve, headache, psychoorganic syndrome and epilepsy. Approximate volume of the tumours ranged from 5 to 212 mL (median: 63 mL). Total or subtotal resection was achieved in 77% of patients. The postoperative performance status improved in 16.5%, did not change in 52.8% and deteriorated in 26.4% of patients. One (3.3%) patient died after the surgery.

Conclusions

The FTOZA is a useful technique for removal of tumours expanding superiorly to the middle cranial fossa base without significant compression of the brain. Ability to remove tumours through the described approach decreases as the degree of infiltration of the clivus increases.

Abstract

Background and purpose

The fronto-temporo-orbito-zygomatic approach (FTOZA) is an alternative to the pterional approach in surgical resection of meningiomas of the medial part of the lesser wing of the sphenoid bone. The purpose of this study is to present our results of treatment of these meningiomas using the FTOZA.

Material and methods

Thirty patients (19 women, 11 men) with a central skull base tumour were included in the study. The neurological status of the patients was assessed before and after surgery as well as at the conclusion of treatment. The approximate volume of the operated tumour, its relation to large blood vessels, cranial nerves and brainstem, as well as consistency and vascularisation were assessed.

Results

The symptom duration ranged from 1 to 36 months (median: 6 months). Impaired visual acuity was the predominant symptom in 27.5% of patients. Less frequent symptoms included paresis/paralysis of the third cranial nerve, headache, psychoorganic syndrome and epilepsy. Approximate volume of the tumours ranged from 5 to 212 mL (median: 63 mL). Total or subtotal resection was achieved in 77% of patients. The postoperative performance status improved in 16.5%, did not change in 52.8% and deteriorated in 26.4% of patients. One (3.3%) patient died after the surgery.

Conclusions

The FTOZA is a useful technique for removal of tumours expanding superiorly to the middle cranial fossa base without significant compression of the brain. Ability to remove tumours through the described approach decreases as the degree of infiltration of the clivus increases.

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Keywords

sphenoid bone, internal carotid artery, meningioma, microsurgery, skull base surgery

About this article
Title

Medial sphenoid ridge meningiomas: early and long-term results of surgical removal using the fronto-temporo-orbito-zygomatic approach

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 44, No 5 (2010)

Pages

464-474

DOI

10.1016/S0028-3843(14)60137-7

Bibliographic record

Neurol Neurochir Pol 2010;44(5):464-474.

Keywords

sphenoid bone
internal carotid artery
meningioma
microsurgery
skull base surgery

Authors

Piotr Ładziński
Henryk Majchrzak
Wojciech Kaspera
Krzysztof Majchrzak
Michał Tymowski
Piotr Adamczyk

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