Meningiomas involving the sphenoid wing outcome after microsurgical treatment--a clinical review of 73 cases.

The authors report on 73 meningiomas involving the sphenoid wing in the outer, middle or inner part of the sphenoid ridge or extending to the orbit. Total resection was achieved in 48 % and a good improvement in visual acuity in 58 % . New, postoperative cranial nerve defi cits were seen in 7 patients. The follow-up was relatively short (29.8 mo), which might explain the observed low recurrence rate of 15 % despite the high number of subtotal resections in this series. Only patients with medial (group 3) or sphenoorbital (group 4) meningiomas (23 % ) underwent postoperative radiotherapy. Remarkable is a mortality rate of 3 % in this benign entity and a relatively high, non-visual, permanent morbidity rate of 7 % in group 3 or 4 patients. Overall, this is a large series of sphenoid wing meningiomas worth publishing. We should always keep in mind that the primary surgical goals and principles include at fi rst preservation of quality of life, followed by the preservation of neurological functions. Nevertheless, the resection should be performed as radical as possible to gain a good tumour control. Radiotherapy should be off ered as an eff ective alternative treatment in recurrent tumours.