Cushing and Eisenhardt first classified globoid sphenoid wing meningiomas (SWM) into medial, middle and lateral groups. The authors examined 29 consecutive patients with globoid shape SWMs that were surgically treated by the senior author (NG). Based on our results, we would like to modify Cushing's classification system of globoid SWM.

All patients who had undergone surgery at two hospitals between 2000 and 2017 were identified. All data from different tumor locations along the sphenoid ridge were compared to determine whether these tumors had different behaviors in presenting symptoms, surgical observation and post-op surgical outcomes.

All 29 consecutive patients with globoid shape of SWM underwent microsurgical resection during this period. The rates of cavernous sinus (CS) invasion (medial 46.1%, lateral 0%, pterional 0%; p 0.01) and vascular encasement (medial 76.9%, lateral 36.3%, pterional 0%; p 0.008) were all highest in medial SWMs. Gross total removal (GTR) was found less in medial SWMs (medial 23%, lateral 63.6%, pterional 100%; p 0.008). Complication rate was higher in medial SWMs (medial 53.8%, lateral 18.1%, pterional 20%, p 0.04). Visual impairment was higher in medial SWMs (medial 92.3%, lateral 36.3%, pterional 40%; p 0.01).

The authors report different entities of meningiomas located along the sphenoid wing, including the presenting symptoms, imaging studies, microsurgical observation, extension of surgical resection, surgical outcome and surgical complication. Our results support the idea to modify Cushing's classification system.

Cushing e Eisenhardt classificaram inicialmente os meningiomas da asa do esfenóide (MAE) globoides em grupos medial, médio e lateral. Os autores examinaram 29 pacientes consecutivos com MAE globoides que foram tratados cirurgicamente pelo autor sênior (NG). Com base em nossos resultados, propomos modificar o sistema de classificação de Cushing para MAE globoides.

Todos os pacientes submetidos à cirurgia em dois hospitais entre 2000 e 2017 foram identificados. Os dados de todos os tumores localizados ao longo da crista do esfenóide foram comparados para determinar se esses tumores apresentavam comportamentos distintos em relação aos sintomas, observação cirúrgica e resultados pós-operatórios.

Todos os 29 pacientes consecutivos com MAE globoides foram submetidos à ressecção microcirúrgica durante esse período. As taxas de invasão do seio cavernoso (SC) (medial 46,1%, lateral 0%, pterional 0%; p 0,01) e de envolvimento vascular (medial 76,9%, lateral 36,3%, pterional 0%; p 0,008) foram todas maiores nos SWMs mediais. A remoção macroscópica total (RMT) foi menos frequente nos SWMs mediais (medial 23%, lateral 63,6%, pterional 100%; p 0,008). A taxa de complicações foi maior nos SWMs mediais (medial 53,8%, lateral 18,1%, pterional 20%, p 0,04). A deficiência visual foi maior nos SWMs mediais (medial 92,3%, lateral 36,3%, pterional 40%; p 0,01).

Os autores relatam diferentes entidades de meningiomas localizados ao longo da asa do esfenoide, incluindo sintomas de apresentação, achados de imagem, observação microcirúrgica, extensão da ressecção cirúrgica, resultados cirúrgicos e complicações cirúrgicas. Nossos resultados apoiam a ideia de modificar o sistema de classificação de Cushing.

Received: 06 September 2025

Accepted: 10 November 2025

Article published online:
29 December 2025

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