Sphenoid Wing Meningiomas: Surgical Strategies and Evaluation of Prognostic Factors Influencing Clinical Outcomes

Objective: To study microsurgical technique and prognostic factors influencing clinical outcomes in a series of 53 patients with sphenoid wing meningiomas. Materials and Methods: The clinical materials of 53 patients with sphenoid wing meningiomas treated microsurgically between January 2008 and January 2012 were analyzed retrospectively. Postoperative follow-up ranged from 6 to 62 months (mean, 34 months). Clinical outcomes including postoperative quality of life and recurrence rate were evaluated. Univariate and multivariate statistical analysis were performed among the factors that might influence postoperative quality of life. Results: In our group, the mean age of patients was 49 years. Mean tumor size was 3.9 cm. Total tumor resection were achieved in 38 cases (71.7%), subtotal in 10 cases (18.9%) and partial resection in 5 cases (9.4%). Within the follow-up period, 10 patients (18.9%) recurred and 3 patients (5.7%) died. Through univariate analysis, we found the postoperative Karnofsky Score (KPS) improvement was determined by various factors, including extent of tumor resection, peritumoral edema, tumor blood supply, size of the tumor, adhesion to the surrounding structures, encasement of major vessels and preoperative Karnofsky score .However, multivariate analysis showed that extent of tumor removal, tumor blood supply, adhesion to the surrounding structures, and encasement of the neurovascular structures were the most influential factors. Conclusions: The extent of tumor removal and intraoperatively defined tumor characteristics played an important role in identifying postoperative functional status. An individual treatment strategy after careful preoperative evaluation could improve quality of life.