Artikel
Surgical resection of pediatric skull base meningiomas
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Veröffentlicht: | 4. Juni 2012 |
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Gliederung
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Objective: Meningiomas in children are rare, especially if located in the skull base region. In this study, we report on our experience with meningioma surgery in the pediatric population and compare our findings of skull base (SB) to non-skull base (NSB) meningiomas.
Methods: Between 1995 and 2010 12 patients (<18 years) harboring meningiomas were surgically treated at our hospital. Patient data were retrospectively collected and statistical analysis was performed using Microsoft Excel and SPSS statistic software. Correlation of the investigated parameters was statistically analyzed by using Fisher's exact test and Student's t-test.
Results: In all 12 children (7 M, 5 F; mean age 12.2 (SD 4.4)) surgical removal of the meningioma was performed microsurgically with a mean follow-up of 52 months (SD 40). No mortality occurred and 2 recurrent tumors were successfully resected in a second surgical procedure. 6 tumors were located in the anterior part of the SB (sphenoid wing (n=1), tuberculum sellae (n=4), olfactory groove (n=1)) and 6 tumors occurred in NSB localizations (convexity (n=2) or parasagittal (n=4)). Although there were no statistically significant differences between the parameters of the 2 groups, the following differences are interesting (SB vs NSB): Mean age of the patients was 11 yrs (SD 3.8) vs. 14 yrs (SD 4.7), male gender 5 vs. 1 patient, mean tumor volume was 37.6 cm3 (SD 37) vs. 167.6 cm3 (SD 123) and mean surgery time was 318 minutes (SD 114) vs. 201 minutes (SD 31), respectively. WHO grade was similar in both groups (SB vs NSB: I 3 vs. 3; II 3 vs. 2; III 0 vs. 1), however Simpson grade (SG) showed a more complete resection in NSB meningiomas (SB vs. NSB: SG1 0 vs. 3; SG2 4 vs. 3; SG3 1 vs. 1; SG4 1 vs. 0). Glasgow outcome scale (GOS) 1 year after surgery was favorable in both groups (SB vs. NSB: GOS4 3 vs. 1, GOS5 3 vs. 5).
Conclusions: Meningioma surgery was safe in the pediatric population with a favorable clinical outcome. Although not statistically significant, SB meningiomas tend to be smaller or present earlier with symptoms, show a higher Simpson grade and occur more likely in younger and male patients, compared to NSB meningiomas.