Abstract
Background
Resection of giant sphenoclinoidal meningiomas (SCLM) remains difficult. We discuss a patient presenting with right eye near blindness who underwent total removal of a giant SCLM, resulting in normal vision and no recurrence.
Method
Utilizing frontotemporal craniotomy, devascularization, debulking, and detachment was achieved. Microdissection of tumor off the optic nerve and carotid perforators was accomplished, resulting in total resection, visual normalization, and no deficits using efficient face-to-face microscope set-up, 2-surgeon 4-hand technique, and double bipolar-suction arrangement.
Conclusion
Frontotemporal craniotomy was adequate. Preservation of the optic nerve and carotid artery is key. Meticulous microsurgical techniques and refined instruments are important for success.
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Abbreviations
- A1:
-
A1 segment of the anterior cerebral artery
- ACP:
-
Anterior clinoid process
- CN III:
-
Oculomotor nerve
- FT:
-
Frontotemporal
- IC:
-
Internal carotid artery
- M1:
-
M1 segment of the middle cerebral artery
- M2:
-
M2 segment of the middle cerebral artery
- MCA:
-
Middle cerebral artery
- ON:
-
Optic nerve
- PCA:
-
Posterior cerebral artery
- Pcom:
-
Posterior communicating artery
- SCLM:
-
Sphenoclinoidal meningioma
- SOF:
-
Superior orbital fissure
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Acknowledgements
We would like to express our gratitude to Lori Radcliffe for the editorial assistance.
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Bawornvaraporn, U., Zomorodi, A.R., Friedman, A.H. et al. How I do it: total resection of a giant sphenoclinoidal meningioma with normalization of near blind vision. Acta Neurochir 163, 2447–2452 (2021). https://doi.org/10.1007/s00701-021-04891-3
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DOI: https://doi.org/10.1007/s00701-021-04891-3