Muhammad Adam Pribadi, Muhammad Wildan Hakim, Nur Setiawan Suroto, Rahadian Indarto Susilo, Irwan Barlian Immadoel Haq
Background: Medial sphenoid wing meningiomas involved to the anterior clinoid process (APC) and located medial on the lesser and greater wing of the sphenoid. Surgical planning of medial sphenoid wing meningiomas must be carefully considered, which in skull base surgery has emphasized the essential of venous preserving and the morbidity when accidentally sacrificed.
Objective: This study aimed to understand the characteristic venous drainage pattern of medial sphenoid wing meningiomas and correlate with surgical planning
Methods: A retrospective analysis evaluation was performed on 7 patients with medial sphenoid wing meningiomas using digital subtraction angiography (DSA) to determine the venous drainage system characteristics before surgery. Classification of the venous drainage pattern from sylvian veins was divided into cortical type, sphenobasal type and cavernous type. Clinical information and postoperative complication were retrospectively reviewed using the patient’s medical and surgical records.
Results: Based on the 7 surgical cases, 5 cases found as cortical type, sphenobasal type was found in 2 cases and did not find the cavernous type. The average tumor volume of cortical and sphenobasal type was 47,7 cm3, 36 cm3 respectively. In this study, one surgical complication was identified, frontal intracerebral hemorrhage (ICH) from postoperative computed tomography (CT) scan evaluation in patients who diagnosed with sphenobasal type.
Conclusion: Complication because venous damage in cases of Medial sphenoid wing meningiomas was rare. However, surgical strategies that aimed to avoid venous complications influenced by venous preservation and a good understanding of venous characteristics.
Keywords: Meningioma, Medial sphenoid wing meningioma, Skull base surgery, Venous drainage