Clinical and surgical aspects of meningiomas at the base of the skull. II. Meningiomas of the middle fossa

INTRODUCTION and objective. In spite of the advances made over the past two decades in neuro anesthesia, neuro radiology and neurosurgical microsurgery, meningiomas of the base of the skull are still a challenge in the field of neurosurgery. In this paper we describe the clinical and surgical characteristics of meningiomas of the middle fossa and our experience in their surgical treatment. PATIENTS AND METHODS. We describe 24 patients who were operated on consecutively for meningiomas of the temporal fossa, lesser wing of the sphenoid and cavernous sinus and the surgical results obtained. RESULTS and conclusions. The results obtained included: 1. Predominance of women for all sites. 2. Age was not a decisive factor when deciding whether to operate or not. 3. The average period between onset of symptoms and diagnosis was two years. 4. In most cases resection of the tumour was total, as confirmed on macroscopy studies. 5. There was a significant increase on the Kamofsky scale postoperatively whatever the site of the tumour resected. 6. The tumours of the cavernous sinus were technically the most difficult to resect surgically. 7. The size of the tumour worsened the preoperative clinical condition and postoperative morbidity.