Microsurgery Of Suprasellar Meningioma And Analysis Of Influence For Prognosis And Recurrence

Objective:To investigate the technique and experience of microsurgery for suprasellae meningiomas and analyze factors influencing prognosis and recurrence.Methods:The clinical materials of 147 patients with suprasellae meningiomas treated between 1985 and 2010 were analyzed retrospectively. All patients underwent microsurgical tumor resection at Neurosurgery Department of Xiangya Hospital by Pr.Yuan Xianrui. Univariate analysis possible factors that may affect the prognosis and recurrence.99 patients were female and 48 male. Patients'age varied from 13 To 73(mean age is 46).Course of disease were between ldays and 30 years(mean time is 36 months).Main clinical manifestations included visual deterioration(95cases)and intracranial hypertension(58 cases).Results:Total tumor resection (SimpsonⅠ,Ⅱ)was achieved in 135 cases and subtotal(SimpsonⅢ) in 6,with the rate of Total tumor resection by 91.8%,and lcase was died.The long term Follow-up of 122 patients were got, and mean Follow-up period was 69.3 months(between 0.5 and 18 years).The mean quality of life score (KPS) was 92.1 in 122 cases, with recurrence 10 cases. Four cases(2.7%) didn't had recurruce afterγ-knife, whose tumor were removed untotally in the surgery. In the follow-up,76 cases has vision loss in preoperation, vision was improved in 54(70.4%), vision stable in 13(17.1%), deteriorated in 9(11.8%).Statistical analysis showed that visual outcome and recurrence correlate to the following factors:age, duration of preoperative visual disturbance, relationship between tumor and optic nerve, direction of tumor invasion, texture and size of tumor, pathologic of tumor, sexual, and extent of tumor removal.Conclusions:1. It is the first option to the cure of suprasellae meningiomas by operation in reason. Adept skilling in neurosurgery will make sure the satisfying prognosis to patients with suprasellae meningiomas.2. It is advantaged for improvement of vision and quality of patients' life with suprasellae meningiomas to diagnose and operate in the first time.3. Trying the best to gain total resection of tumor is a very important measure. Relationship between tumor and bone and extent of tumor removal is related to recurrence of tumor.4. Gamma ray is a believable treatment for patients with tumor subtotal resected.