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

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 radios...

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Autores principales: Starnoni, Daniele, Tuleasca, Constantin, Levivier, Marc, Daniel, Roy T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Vienna 2022
Materias:
How I Do it - Tumor - Meningioma
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9427927/
https://www.ncbi.nlm.nih.gov/pubmed/35761109
http://dx.doi.org/10.1007/s00701-022-05281-z
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author Starnoni, Daniele
Tuleasca, Constantin
Levivier, Marc
Daniel, Roy T.
author_facet Starnoni, Daniele
Tuleasca, Constantin
Levivier, Marc
Daniel, Roy T.
author_sort Starnoni, Daniele
collection PubMed
description 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00701-022-05281-z.
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spelling pubmed-94279272022-09-01 Surgery for clinoidal meningiomas with cavernous sinus extension: Near-total excision and chiasmopexy Starnoni, Daniele Tuleasca, Constantin Levivier, Marc Daniel, Roy T. Acta Neurochir (Wien) How I Do it - Tumor - Meningioma 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00701-022-05281-z. Springer Vienna 2022-06-27 2022 /pmc/articles/PMC9427927/ /pubmed/35761109 http://dx.doi.org/10.1007/s00701-022-05281-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle How I Do it - Tumor - Meningioma
Starnoni, Daniele
Tuleasca, Constantin
Levivier, Marc
Daniel, Roy T.
Surgery for clinoidal meningiomas with cavernous sinus extension: Near-total excision and chiasmopexy
title Surgery for clinoidal meningiomas with cavernous sinus extension: Near-total excision and chiasmopexy
title_full Surgery for clinoidal meningiomas with cavernous sinus extension: Near-total excision and chiasmopexy
title_fullStr Surgery for clinoidal meningiomas with cavernous sinus extension: Near-total excision and chiasmopexy
title_full_unstemmed Surgery for clinoidal meningiomas with cavernous sinus extension: Near-total excision and chiasmopexy
title_short Surgery for clinoidal meningiomas with cavernous sinus extension: Near-total excision and chiasmopexy
title_sort surgery for clinoidal meningiomas with cavernous sinus extension: near-total excision and chiasmopexy
topic How I Do it - Tumor - Meningioma
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9427927/
https://www.ncbi.nlm.nih.gov/pubmed/35761109
http://dx.doi.org/10.1007/s00701-022-05281-z
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