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Objective To explore the microsurgical technique of medial sphenoid ridge meningioma resectional therapy.Methods The clinical data were retrospectively analyzed of 29 patients(13 males and 16 females;aged 18-68 years with average of 42 years;duration of disease was 5 months to 8 years,averaged 28 months) with medial sphenoidal ridge meningioma and admitted from Jan.2005 to Jan.2010.The anatomical relationship of the tumor to surrounding structures was assessed intraoperatively,the tumor was then completely resected through cutting off the tumor supplying vessels,shrinking the tumor volume and separating the tumors from adjacent vessels and nerves.All the patients were followed up for 4 months to 4 years.Results Of the 29 cases,20 got total tumor removal,7 got subtotal and 2 got partial tumor removal.Of the 20 patients with obviously preoperative visual impairment,12 were obviously relieved,6 showed no improvement and 2 got symptoms aggravation.Hemiplegia occurred in 2 cases and oculomoter nerve palsy in 6 cases.There was no death after surgery.A 6 months to 4 years follow-up showed that no recurrence was found in 27 patients with tumor resection level of Simpson I and II,2 patients with tumor resection level of Simpson III received postoperative radiotherapy or gamma knife surgery,and 1 recurred and received reoperation.Conclusions Fine intraoperative assessment of the anatomical relationship of the tumor to surrounding structures,separating and excising tumor according to the assessed result is the key of medial sphenoid ridge meningioma resection,and the tumor resection is favorable to visual rehabilitation and tumor control.

Objective To explore the surgical technique for excision of mid-superior petroclival region tumor through subtemporal transtentorial approach.Methods Forty-three patients with tumor at superior-middle petroclival region hospitalized from Jun.20003 to Apr.2010 were involved in present study,and their clinical data were retrospectively analyzed.Of the 43 patients,19 were male and 24 were female,age ranged from 23 to 64 years(with mean of 42 years),disease duration ranged from 2 months to 3 years(with average of 14 months).All the patients underwent tumor resection via subtemporal transtentorial approach.The relationship between tumors and adjacent superior-middle petroclival structures was evaluated,and then the adhesion between tumor and tentorium cerebelli or petroclival meninges was separated,the tumor was resected piecemeal from closest area to distant part.The arachnoidal planes between tumor and brain stem,hypothalamus,or cavernous was dissected to enlarge the gap between the tumor and brain tissue,at the same time avoiding irritation to the above important structures.The therapeutic effects and postoperative complications were recorded.Results Total resection was achieved in 31 cases(72.1%),subtotal resection in 7 cases(16.2%),and partial resection in 5 cases(11.6%).One patient died(3.3%).Twenty-three patients developed new postoperative neurological deficits.The patients were followed up for 3 to 48 months,and the neurological functions were found to recover in varying degrees.Conclusion Subtemporal transtentorial approach for excision of tumors at superior-middle petroclival region has advantages of shorter approach and easy to expose.The key of the operative procedure is to reduce the tumor volume and enlarge the operative space.