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| Name | Microsurgical Resection of Large Medial Sphenoid Wing Meningiomas: Technique |
| Video Uploader | Video From NEUROSURGERY Journal |
| Upload Date | This Video Uploaded At 28-05-2013 17:50:20 |
| Video Discription | Resection of medial sphenoid wing meningiomas poses surgical challenges due to close contact with important cerebrovascular structures. The standard treatment for large tumors is microsurgical resection. Complete removal includes maximal resection of the dura and any involved bone, but this approach is not always feasible when the tumor encases the arteries or cranial nerves. In these cases, there is evidence that a more conservative resection followed by radiation treatment can reduce operative morbidity with acceptable tumor control rates. In this 3-D video, the authors demonstrate their preferred technical nuances to resect a large middle to medial sphenoid wing meningioma. The patient is a 41-year-old man with a large left sphenoid wing meningioma found during routine imaging after a minor head trauma. MRI evaluation revealed minimal edema associated with this tumor. The resection was performed via a standard pterional craniotomy and drilling of the sphenoid wing. Important steps in resection of this tumor include: 1) tumor devascularization extradurally and then intradurally, 2) tumor debulking, 3) microdissection of middle cerebral artery branches and corresponding perforators from tumor capsule, 4) identification of optic nerve and internal carotid artery at the skull base, and 5) tumor capsule dissection to expose the distal internal carotid artery and proximal middle cerebral artery. In this case, the tumor adhered to but did not encase the arterial trunks/perforators or the cranial nerves. Complete resection was achieved and most of the dura at the base of implantation was resected or heavily cauterized. The patient remained neurologically intact after surgery. |
| Category | Science & Technology |
| Tags | Sphenoid | wing | meningioma |
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