Surgical Technique: An Overview

Meningiomas of different locations require varying surgical approaches that are primarily dictated by anatomic considerations inherent to each particular tumor location.  Additional factors that lead to variations in surgical approach include the surgeon’s personal experience and preference.

The following basic principles hold for meningioma surgery of most locations:

  1. Optimal patient positioning and incision
  1. Craniotomy (skull opening), dural opening and the tumor exposure
  1. Early tumor devascularizaion (“cutting off the blood supply to the tumor”)
  1. Internal decompression and extracapsular dissection
  1. Early localization and preservation of adherent or adjacent neurovascular structures (the brain tissue, cranial nerves, blood vessels)
  1. Removal of the involved bone and dura
  1. Optimal dural reconstruction and operative wound closure


Additional reading:

Management Options and Surgical Principles: An Overview

Surgical Management of Convexity Meningiomas

Surgical Technique for Removal of Clinoidal Meningiomas

Lee JH, Sade B:  Management Options and Surgical Principles:  An Overview.  In:  “Meningiomas” (JH Lee, ed.), pp. 203-207, Springer, London, 2008

Steinmetz MP, Krishnaney A, Lee JH:  Surgical Management of Convexity Meningiomas.  In:  Neurosurgical Operative Atlas – Neuro-Oncology (Badie B, ed.), pp. 145-152, Thieme, NYC, 2007

Lee JH, Evans JJ, Steinmetz MP, Kwon JT.  Surgical Technique for Removal of Clinoidal Meningiomas.  In:  Neurosurgical Operative Atlas – Neuro-Oncology (Badie B., ed.), pp. 153-160, Thieme, NYC, 2007

Oya S, Sade B, Lee JH:  Spheno-orbital meningioma:  Surgical Technique and Outcome.  J Neurosurg 114:1241-1249, 2011

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