Interdisciplinary Neurosurgery (Mar 2023)
Surgical and functional outcomes of microsurgical resection of tentorial meningiomas: A single-center study
Abstract
Background: Tentorial meningiomas are uncommon entity, related to tentorium and representing 3–6% of intracranial meningiomas. Being related to surrounding vital neurovascular structures, complete surgical resection of such tumors was limited in the early stages with poor outcomes, but with the continuous improvements in microsurgery and the advent of new imaging modalities, the prognosis of such cases has improved significantly. We aimed to assess different surgical approaches, and functional outcome of patients with tentorial meningioma who underwent microsurgical resection at a single institution in a developing country. Methods: A Retrospective analysis of clinical data of tentorial meningioma patients who underwent microsurgical excision at our institution between 2014 and 2021 was done. Tumour characteristics, location based on the modified Yasargil classification, different surgical approaches, operative details, extent of resection, and functional postoperative outcome according to modified Rankin scale were also assessed. Results: 18 patients diagnosed with tentorial meningioma were included in our study, (66.7% females and 33.3% males) with mean age (50.1 ± 8.6) years. Headache was the most common presentation in (83.3%) of our patients and 5 patients (27.8%) had preoperative hydrocephalus. Gross total resection had been achieved in 66.7% of patients, while 16.7% of patients had subtotal resection and 16.7% had partial resection. 12 patients were considered in the (Good outcome) group and had score from 0 to 2 in the modified Rankin scale, while 6 cases had (Poor outcome) were between 3 and 6 on the scale. Factors that might predict the functional outcome were evaluated and were statistically insignificant. Conclusion: Tentorial meningiomas are challenging, microsurgical excision results in favorable surgical and functional outcome in most cases however, when gross total resection isn’t feasible, subtotal resection followed by adjuvant therapy is recommended.
