Background: Clinoidal meningiomas remain challenging tumors
that represents a difficult task to the neurosurgeon. Tumors with orbital or
cavernous extensions require meticulous surgical planning, as they directly
affect postoperative recovery. Different surgical techniques have been used
aiming at reaching a satisfactory outcome. Objective: Evaluate the role of different available surgical
options in patients with clinoidal meningiomas so as to achieve a safe
resection of the tumor. Methods: In 14 patients who were operated upon for anterior clinoidal meningioma
in Cairo University Hospitals between 2007 and 2011, the surgical approach,
clinical outcome and extent of resectability were all analyzed. Results: Gross total tumor resection was achieved in 79% of
the cases. 11 Tumors were resected via a standard pterional approach. 3 cases
had intra cavernous extension and were sub-totally removed. Three cases had intraorbital extensions, for
those, a modified extradural skull base technique with was used with total
removal of the tumor and the intraorbital extension. Post operative visual
improvement occurred in 46% of patients. Conclusion: Involvement of the optic canal in clinoidal
meningiomas is a prominent factor that affects the postoperative visual
outcome. The overall surgical outcome is guided not only by the extent of tumor
resection but also by the extent of optic nerve decompression .In each case,
the surgical approach should be tailored according to the needs in each case
individually for better outcome. [Egypt
J Neurol Psychiat Neurosurg. 2012; 49(1): 1-6]
Key Words: Skull Base Surgery, Sphenoid
wing, Anterior Clinoid Meningioma, Clinoidectomy.
Correspondence to
Omar M. El-Falaky, Department of Neurosurgery, Cairo University, Egypt.
Tel.: +201223954993 E-mail:
omarfalaky@hotmail.com