C4: Anterior and middle skull base meningiomas: Experience from a sub-Saharan country of a serie of 56 cases

INTRODUCTION: Skull base meningiomas represent 25% of all meningiomas. Mostly slow-growing, the challenge lies in their relationship with the circle of Willis and cranial nerves. The objective of our study was to evaluate the management of meningiomas of the anterior and middle cranial fossa in a sub-Saharan setting. MATERIALS AND METHODS: A serie of 56 patients hospitalized for meningiomas of the anterior and middle cranial fossa were retrospectively reviewed and analyzed, from January, 2012 to December, 2018. RESULTS: Anterior and middle cranial fossa meningiomas represented 32.7% of intracranial meningiomas in the department. The mean age was 50.5 years and the sex-ratio were 0.3. Clinical manifestations were dominated by visual disorders (57.1%) and intracranial hypertension (26.8%). The mean tumor size was 54.3 mm. The pterional approach was used on 94.6% of patients. The quality of resection was SIMPSON grade II in 71.4% of cases. Postoperative mortality was 14.2%. The pathology was grade I in 91.1% of cases. Over a three-year follow-up, complete recovery was noted in 67.8% of cases. Two cases had recurrence. CONCLUSION: Meningiomas are the most common tumor of the anterior and middle cranial fossa in the institution. Microsurgical excision was the only treatment performed. Complete recovery without sequelae was observed in 67.8% of cases. The improvement in the instrumentation and neuro-intensive care helped to reduce mortality and morbidity, but efforts still need to be made, especially in the development of complementary treatments.