[Analysis of the causes of surgical complications of medial sphenoidal ridge meningioma].

OBJECTIVE

To find out the causes of severe surgical complications of sphenoidal ridge meningioma of and the methods to avoid them.

METHODS

The clinical data of 56 cases of sphenoidal ridge meningioma, 37 being medial (clinoidal) type, 5 being middle (alar) type, and 14 being lateral (pterional) type, with the diameters of 3.5 - 7 cm, 3.8 - 5.2 cm, and 3.8 - 7.5 cm respectively, who underwent operation.

RESULTS

The tumors of 19 cases of lateral and middle types were resected completely without surgical complication. Facial nerve injury occurred in 2 cases of medial type because of failure to know well the course of facial nerve and over-stretching of skin flap. Oculomotor nerve injury occurred in 7 cases, 5 of which were transient, and trochlear nerve injury occurred in 1 case, all caused by inappropriate manipulations. Too early resection of tumor-related vessel caused middle cerebral artery injury in one case. Resection of the tumor infiltrating the carotid artery inadequately caused injury of the carotid artery. Lenticulostriate artery injury was caused in 2 cases by over-separation of the lateral fissure.

CONCLUSION

Severe surgical complications can be avoided if the surgeons, with great skills, are able to predict different topographic changes and difficulties encountered during operation in the light of the specific conditions in operation.