Predictors of visual outcome following surgical resection of medial sphenoid wing meningiomas

Kaisorn L. Chaichana, Christopher Jackson, Amar Patel, Neil R. Miller, Prem Subramanian, Michael Lim, Gary Gallia, Alessandro Olivi, Jon Weingart, Henry Brem, Alfredo Quinones-Hinojosa

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: Medial sphenoid wing meningiomas (SWMs) are relatively common tumors that are associated with significant morbidity and mortality, primarily from their anatomic proximity to many critical neurological and vascular structures. A major complication is visual deterioration. This study aimed to identify predictors of visual outcome following medial SWM resection. Design: Retrospective, stepwise multivariate proportional hazards regression analysis. Setting: Johns Hopkins Hospital. Participants: All patients who underwent medial SWM resection from 1998 to 2009. Main Outcome Measures: Visual function. Results: Sixty-five medial SWM resections were performed. After multivariate proportional hazards regression analysis, preoperative visual decline (relative risk [RR] 95% confidence interval [CI]; 13.431 [2.601 to 46.077], p = 0.006), subtotal resection (RR [95% CI]; 3.717 [1.204 to 13.889], p = 0.02), and repeat surgery (RR [95% CI]; 5.681 [1.278 to 19.802], p = 0.03) were found to be independent predictors of visual decline at last follow-up. Tumor recurrence and postoperative radiation therapy trended toward, but did not reach statistical significance. Conclusion: These findings advocate for early and aggressive surgical intervention for patients with medial SWMs to maximize the likelihood of subsequent visual preservation. This may provide patients and physicians with prognostic information that may guide medical and surgical therapy for patients with medial SWMs.

Original languageEnglish (US)
Pages (from-to)321-326
Number of pages6
JournalJournal of Neurological Surgery, Part B: Skull Base
Volume73
Issue number5
DOIs
StatePublished - 2012
Externally publishedYes

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Meningioma
Confidence Intervals
Regression Analysis
Reoperation
Blood Vessels
Neoplasms
Radiotherapy
Outcome Assessment (Health Care)
Morbidity
Physicians
Recurrence
Mortality

Keywords

  • Meningioma
  • Outcomes
  • Risk factors
  • Sphenoid wing
  • Vision loss

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Predictors of visual outcome following surgical resection of medial sphenoid wing meningiomas. / Chaichana, Kaisorn L.; Jackson, Christopher; Patel, Amar; Miller, Neil R.; Subramanian, Prem; Lim, Michael; Gallia, Gary; Olivi, Alessandro; Weingart, Jon; Brem, Henry; Quinones-Hinojosa, Alfredo.

In: Journal of Neurological Surgery, Part B: Skull Base, Vol. 73, No. 5, 2012, p. 321-326.

Research output: Contribution to journalArticle

Chaichana, KL, Jackson, C, Patel, A, Miller, NR, Subramanian, P, Lim, M, Gallia, G, Olivi, A, Weingart, J, Brem, H & Quinones-Hinojosa, A 2012, 'Predictors of visual outcome following surgical resection of medial sphenoid wing meningiomas', Journal of Neurological Surgery, Part B: Skull Base, vol. 73, no. 5, pp. 321-326. https://doi.org/10.1055/s-0032-1321510
Chaichana, Kaisorn L. ; Jackson, Christopher ; Patel, Amar ; Miller, Neil R. ; Subramanian, Prem ; Lim, Michael ; Gallia, Gary ; Olivi, Alessandro ; Weingart, Jon ; Brem, Henry ; Quinones-Hinojosa, Alfredo. / Predictors of visual outcome following surgical resection of medial sphenoid wing meningiomas. In: Journal of Neurological Surgery, Part B: Skull Base. 2012 ; Vol. 73, No. 5. pp. 321-326.
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AU - Lim, Michael

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AB - Objective: Medial sphenoid wing meningiomas (SWMs) are relatively common tumors that are associated with significant morbidity and mortality, primarily from their anatomic proximity to many critical neurological and vascular structures. A major complication is visual deterioration. This study aimed to identify predictors of visual outcome following medial SWM resection. Design: Retrospective, stepwise multivariate proportional hazards regression analysis. Setting: Johns Hopkins Hospital. Participants: All patients who underwent medial SWM resection from 1998 to 2009. Main Outcome Measures: Visual function. Results: Sixty-five medial SWM resections were performed. After multivariate proportional hazards regression analysis, preoperative visual decline (relative risk [RR] 95% confidence interval [CI]; 13.431 [2.601 to 46.077], p = 0.006), subtotal resection (RR [95% CI]; 3.717 [1.204 to 13.889], p = 0.02), and repeat surgery (RR [95% CI]; 5.681 [1.278 to 19.802], p = 0.03) were found to be independent predictors of visual decline at last follow-up. Tumor recurrence and postoperative radiation therapy trended toward, but did not reach statistical significance. Conclusion: These findings advocate for early and aggressive surgical intervention for patients with medial SWMs to maximize the likelihood of subsequent visual preservation. This may provide patients and physicians with prognostic information that may guide medical and surgical therapy for patients with medial SWMs.

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