RESUMEN
Objective To introduce the microsurgery treatment method for large parasellar meningiomas by pterional craniotomy and its curative effect. Methods The clinical data of 34 patients with large parasellar meningiomas, who underwent microsurgery via pterional or extensive pterional craniotomy in Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine Jul. 2006 to Aug. 2016, were retrospectively analyzed. The patients included 13 men and 21 women with ages ranging from 21 to 72 (average, 49±13) years old. The course of disease ranged from 1 to 55 (average, 13±10) months. Maximum diameter of tumors ranged from 3.3 to 5.2 (average, [4.3±0.6]) cm. Results No surgical death occurred in this study. Postoperatively, the cranial imaging examination showed that 24 of 34 cases were totally removed, 5 cases were subtotally removed, and 5 cases were partially removed. The postoperative follow-up time was 24-48 (average, 36±13) months. Twenty-eight cases had good prognoses with Karnofsky score being 80 to 100, and six cases had fair prognoses with Karnofsky score being 60 to 79. Five cases had postoperative oculomotor paralysis, which was improved with nutritional nerve treatment. Conclusion The microsurgical treatment via pterional or extensive pterional craniotomy can improve the total resection rate of the large parasellar meningiomas. Palliative operations combined with postoperative radiotherapy may be employed for the tumors that can only be subtotally and partially removed.