LONG-TERM FUNCTIONAL OUTCOMES OF NEODYMIUM LASER–ASSISTED RESECTION OF BASAL AND PARASAGITTAL MENINGIOMAS

Аннотация

Basal and parasagittal meningiomas represent some of the most surgically challenging intracranial tumors due to their close relationship with major venous sinuses, cranial nerves, and functionally significant brain structures. The absence of a unified surgical strategy, particularly in cases involving invasion of the superior sagittal sinus, contributes to a high incidence of postoperative neurological deficits and tumor recurrence. The present study aimed to evaluate the long-term effectiveness of neodymium laser–assisted microsurgical techniques in the resection of basal and parasagittal meningiomas by assessing cerebral hemodynamics and electroencephalographic parameters in the late postoperative period. A total of 389 patients operated on between 1995 and 2009 were analyzed more than five years after surgery. Patients were divided into a comparison group treated with standard microsurgical methods and a study group in which neodymium laser technology (wavelength 1.064 μm) was used at key stages of tumor resection. Long-term outcomes were assessed using electroencephalography and transcranial Doppler sonography. Laser-assisted surgery was associated with a higher rate of radical tumor removal, lower postoperative mortality, better preservation of cerebral blood flow, and a significantly lower frequency of pathological EEG changes, including midline structure dysfunction and epileptiform activity. These findings indicate that neodymium laser technologies reduce surgical trauma and improve long-term functional outcomes in patients with complex basal and parasagittal meningiomas.