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Journal of Korean Neurosurgical Society > Volume 28(6); 1999 > Article
Journal of Korean Neurosurgical Society 1999;28(6): 817-822.
Surgical Approach to Large Anterior Basal Meningioma.
Hyung Kyun Rha, Kyung Jin Lee, Kyung Keun Cho, Sung Chan Park, Hae Kwan Park, Jeung Ki Jo, Chul Ji, Sang Weon Lee, Jun Ki Kang, Chang Rak Choi
Catholic University, Catholic Neuroscience Center, Seoul, Korea.
Anterior basal meningiomas, which belong the olfactory groove and suprasellar meningioma account for 12 to 22% of all intracranial meningioma. Anterior cranial base meningioma are difficult to operate on because of their proximity to the important neurovascular structure. The authors report 25 cases of large meningiomas of the anterior. cranial base operated on during recent 5-year period. The tumor ranged from 3cm to 6.5cm in diameter. Fifteen tumors were located in the suprasellae(included tuberculum sellae, planum sphenoidale, diaphragma sellae,and anterior clinoid process), ten on olfactory groove. The mean age of 19 female and 6 male patient was 55years. The main clinical symptom were visual disturbance, anosmia, headache, and psychotic syndrome. Tumors were approached in 11 cases by pterional, in 9 cases by bifrontal, in 3 cases by transbasal, in 2 case by orbitozygomatic infratemporal and in 1 case by combined approach with tranabasal and orbitozygomatic infratemporal. Total tumor removal was performed in 80% of cases. Postoperative complication include accentuated psychotic syndrome in two cases, worsening of visual function in two, major vessel injury in one, infection in one, CSF rhinorrhea in one, and oculomotor palse in one. Postoperative death was in four(16%). Results at follow up of the 21 survivours were good in 17(68%), fair in 4(16%). Selection criteria for operative approach is discussed with review of pertinent literature.
Key Words: Anterior Basal Meningioma; Surgical Approach; Surgical Result
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