46 patients treated for medial sphenoid wing meningioma from 2014 to 2019 to evaluate their location, volume, cavernous sinus involvement, vascular encasement, and bone invasion by 3D multimodality fusion imaging. A scoring system based on the significant parameters detected by statistical analysis was created and evaluated.

The tumor volumes ranged from 0.8 cm3 to 171.9 cm3. A total of 39 (84.8%) patients had arterial involvement. Cavernous sinus (CS) involvement was observed in 23 patients (50.0%) and bone invasion was noted in 10 patients (21.7%). Simpson I resection was achieved in 10 patients (21.7%) and Simpson II resection was achieved in 17 patients (37.0%). Fifteen patients (32.6%) underwent Simpson III resection and 4 patients (8.7%) underwent Simpson IV resections. A scoring system was created. The score ranged from 1 to 10 and the mean score of our patients was 5.3 ± 2.8. Strong positive monotonic correlation existed between the score and resection grade (Rs = 0.772, P < 0.001). The scoring system had good predictive capacity with an accuracy of 69.60%.

Wang et al. described a scoring system that enabled neurosurgeons to predict extent of resection and outcomes for mSWM preoperatively with 3D multimodality fusion imaging ¹⁾.

A procedure employed in removing meningiomas of the ala parva and of meningiomas affecting simultaneously ala parva and ala magna is described. Materials derived from operative interventions in 78 patients are studied. The application of the microsurgical technique in separating meningiomas from basilar arteries made it possible to improve the effectiveness of operative interventions. The overall post operative lethality comprised 24.3 per cent ²⁾.