蝶骨翼脑膜瘤伴海绵窦浸润(SWMCSI)是具有挑战性的肿瘤。生活质量和颅神经功能的保持是治疗SWMCSI患者的最相关方面之一。
对2008年至2021年进行的手术进行了回顾性研究,包括36例出现SWMCSI的患者。手术干预的数据,辛普森级切除,肿瘤位置,并回顾了与手术相关的死亡率。我们检查了病历,手术报告,放射学检查,和后续信息。
该组由29名女性和7名男性组成,平均年龄为61岁(范围,31-87岁)。平均随访时间为75个月(范围,1-170个月)。在80%的病例中获得了辛普森I级和II级切除。94%的脑膜瘤为世界卫生组织(WHO)的1级,世卫组织2级3%,和世界卫生组织3级3%。总死亡率为5.5%。永久性颅神经缺损发生在8%的病例中,短暂性颅神经缺损占22%,脑脊液瘘占16.5%,偏瘫占2.7%。随访期间复发/再生长率为14%。Karnofsky性能状态100和90为92%。
有症状的SWMCSI的手术治疗是一种有效的治疗方式,病态低,疾病长期控制良好。视力障碍是最常见的异常,影响SWMCSI患者术前和术后生活质量。显微外科实验室的培训对于该领域的安全手术方法至关重要。
Sphenoid wing meningiomas with cavernous sinus invasion (SWMCSI) are challenging tumors. The preservation of quality of life and cranial nerve function is one of the most relevant aspects of treating patients with SWMCSI.
A retrospective study was conducted for surgery performed between 2008 and 2021, including 36 patients presenting with SWMCSI. The data from surgical intervention, Simpson grade of resection, tumor location, and morbimortality related to the surgery was reviewed. We examined the medical records, operative reports, radiologic examinations, and follow-up information.
The group comprised 29 women and 7 men with an average age of 61 years (range, 31-87 years). The mean follow-up period was 75 months (range, 1-170 months). Simpson grade I and II resections were obtained in 80% of cases. The meningiomas were World Health Organization (WHO) grade 1 in 94% of cases, WHO grade 2 in 3%, and WHO grade 3 in 3%. The overall mortality was 5.5%. Permanent cranial nerve deficits occurred in 8% of cases, transient cranial nerve deficits in 22%, cerebrospinal fistula in 16.5%, and hemiparesis in 2.7%. The recurrence/regrowth rate was 14% during the follow-up period. The Karnofsky Performance Status 100 and 90 was 92%.
The surgical treatment of symptomatic SWMCSI is an effective treatment modality with low morbimortality and good long-term control of the disease. Visual impairment is the most common abnormality, affecting preoperative and postoperative quality of life of patients with SWMCSI. Training in the microsurgical laboratory is essential for safe surgical approaches in this area.