Different surgical approaches for middle cranial fossa meningiomas / Ahmed Mohamed Salah Eldin ; Supervised Helmy Abdelhalim Eldessouky , Magdy Khairy Samra , Ahmed Mostafa Kersh

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Neurosurgery

Comparing different surgical approaches for middle cranial fossa meningiomas to determine the best approach achieving maximal removal and maximum safety for each type. Patients with meningiomas from different points of origin in the middle cranial fossa will be operated upon using different approaches appropriate for each type. The patients will be investigated and evaluated preoperatively. Post-operative they were followed for the extent of resection and complications. 30 patients were operated in this study and were 7 cases of clinoidal, 5 cavernous sinus cases, 4 petrous apex cases, 4 cases of tuberculum sellae, 2 cases of middle fossa floor, 3 cases of meningioma en plaque, 2 cases of pterional, one case of alar, one case of whole sphenoid wing meningioma and one case of diaphragm sellae meningioma. Pterional approach was used in 19 cases, Dolenc approach in 3 cases, Kawase approach in 3 cases, frontolateral approach in 3 cases, subtemporal approach in one case and extended endonasal approach in one case. Cranial nerve affection was the most common presentation and post-operative complication. Middle fossa meningiomas are very common and surgically challenging for surgeons due to proximity to major vascular structures, cavernous sinus and cranial nerves which the most common pre and post-operative morbidity. Proper surgical approach for each type helps radicality and decreasing morbidities and mortalities

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