Long-term prognosis of the total excision of sponge sinus meningioma and decompression surgery

Yair MGozal of the University of Utah Neurosurgery and others evaluated the prognosis of secondary excision and decompression surgery for patients with spongy sinus meningioma surgery over a 15-year period from 2002 to 2017, and published the results online in J Neurosurg in February 2019- From the article chapter
(Ref: Gozal YM, et alJ Neurosurg2019 Feb 15:1-8doi: 10.3171/2018.10.JNS181480Thespongossus meningiomas accounted for 41% of all sinus tumorsThe anatomical structure of the sponge sinus is special, containing a large number of veins and intra-cervical arteries, so it has always been considered a "surgical exclusion zone"With the advance of microsurgical techniques and the improvement of understanding of spongy sinus anatomy, neurosurgeons' attitude towards the treatment of spongiform sinus meningioma gradually turned to active surgical excisionCurrently, treatment options for meningioma in this area include follow-up, surgical excision, and stereotactic radiosurgery (stereotactic radiosurgery, SRS)For meningiomas, which are small in size or confined to spongy sinuses, SRS can better control tumors and have fewer complicationsSponge sinus meningioma compresses the optic nerve complex causing different degrees of vision impairment is a sign of surgical removal of the tumorthe University of Utah Clinical Neuroscience Center neurosurgery on the treatment of spongiform sinus meningioma, first, the safe removal of tumors, as far as possible to reduce the risk of nerve vascular damage; Yair MGozal of the University of Utah Neurosurgery and others evaluated the prognosis of secondary excision and decompression surgery for patients with spongy sinus meningioma surgery over a 15-year period from 2002 to 2017, and published the results online in J Neurosurg in February 2019this retrospective study, including 50 patients with spongy sinus meningioma from 2002 to 2017, all received so-called subtotal excision plus decompression, i.e through the cerebellum to perform tumor sub-total excision, and at the same time spongy sinus and isocyatic neurodejuum The prognostic indicators of the patient were recorded and analyzed, including cranial nerve function, tumor control rate, and surgical complications The average follow-up time was 64.6 months of all patients, the main signs of surgery were tumor-related symptoms, 26 cases of headache (52%), 31 cases of visual impairment (62%), 35 cases of secondary eye palsy (70%), 22 cases of eye protrusion (44%) and 4 cases of new epilepsy (8%) (Table 1) Of these, 25 (50%) patients were treated with SRS for residual tumors in the sinuses of the sponge table 1 Demographic characteristics and clinical information of patients In the 35 (70%) patients with preoperative cranial neurofunctional disorders, 52% of the neurofunctions improved after surgery, 46% remained stable and only 2% deteriorated It is worth noting that 12 cases of new cranial neurodysfunction occurred after 10 cases, 50% of which were temporary and eventually recovered 97% of patients with preoperative vision impairment improved or remained stable after surgery 5 cases (10%) tumor recurrence was found by imaging examination, the average recurrence time is 4.6 years authors believe that whether or not SRS-assisted treatment is used, secondary total excision and conservative decompression surgery to treat spongiform meningioma is an effective treatment strategy, can better control the tumor, and reduce the risk of nerve damage.