Surgery for clinoidal meningiomas with cavernous sinus extension: Near-total excision and chiasmopexy.


Journal

Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000

Informations de publication

Date de publication:
09 2022
Historique:
received: 09 03 2022
accepted: 28 05 2022
pubmed: 28 6 2022
medline: 3 9 2022
entrez: 27 6 2022
Statut: ppublish

Résumé

The main factors limiting the extent of resection for clinoidal meningiomas are cavernous sinus extension and vessel adventitia involvement. The proximity to the optic apparatus and the risk of radiation-induced optic neuropathy often prevents many surgeons from proposing adjuvant radiosurgery. We describe a simple technical solution that is to place a fat graft between the optic apparatus and the residual tumor to maintain the distance gained at surgery and facilitates the identification of anatomic structures. This technique allows to deliver optimal therapeutic doses to the residue reduces the dose received by the optic nerve below 8 Gy.

Sections du résumé

BACKGROUND
The main factors limiting the extent of resection for clinoidal meningiomas are cavernous sinus extension and vessel adventitia involvement. The proximity to the optic apparatus and the risk of radiation-induced optic neuropathy often prevents many surgeons from proposing adjuvant radiosurgery.
METHOD
We describe a simple technical solution that is to place a fat graft between the optic apparatus and the residual tumor to maintain the distance gained at surgery and facilitates the identification of anatomic structures.
CONCLUSION
This technique allows to deliver optimal therapeutic doses to the residue reduces the dose received by the optic nerve below 8 Gy.

Identifiants

pubmed: 35761109
doi: 10.1007/s00701-022-05281-z
pii: 10.1007/s00701-022-05281-z
pmc: PMC9427927
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2511-2515

Informations de copyright

© 2022. The Author(s).

Références

Neurochirurgie. 2017 Sep;63(4):336-340
pubmed: 28882601
Acta Neurochir (Wien). 2021 Dec;163(12):3387-3400
pubmed: 34398339
J Neurosurg. 1983 Jun;58(6):824-31
pubmed: 6854374
Neurosurgery. 2002 Oct;51(4 Suppl):S335-74
pubmed: 12234453
Radiat Oncol. 2019 Nov 12;14(1):201
pubmed: 31718650
Neurosurgery. 2014 Oct;75(4):456-60; discussion 460
pubmed: 24902082
Acta Neurochir (Wien). 2016 Nov;158(11):2235-2236
pubmed: 27663880
Neurosurgery. 2018 Dec 1;83(6):1128-1142
pubmed: 29554317
World Neurosurg. 2019 Sep;129:e700-e717
pubmed: 31176836

Auteurs

Daniele Starnoni (D)

Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Neurosurgery Service and Gamma Knife Center, Lausanne, Switzerland. Daniele.starnoni@chuv.ch.
Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland. Daniele.starnoni@chuv.ch.

Constantin Tuleasca (C)

Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Neurosurgery Service and Gamma Knife Center, Lausanne, Switzerland.
Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland.
Signal Processing Laboratory (LTS 5), Ecole Polytechnique Fédérale de Lausanne (EPFL) , Lausanne, Switzerland.

Marc Levivier (M)

Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Neurosurgery Service and Gamma Knife Center, Lausanne, Switzerland.
Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland.

Roy T Daniel (RT)

Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Neurosurgery Service and Gamma Knife Center, Lausanne, Switzerland.
Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland.

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