To investigate the effects of anterior clinoid process (ACP) grinding and optic canal opening on the resection of anterior clinoid meningioma (ACM), and to clarify the benefits and feasibility of anterior clinoid process grinding and optic canal decompression.

The clinical data of 63 cases with ACM who were surgically treated by the author from July 1999 to June 2021 were analyzed retrospectively, including 13 cases of epidural ACP grinding, optic canal roof removal and optic sheath opening; 36 cases underwent standard frontotemporal craniotomy, of which 6 cases underwent intradural ACP grinding and opening of the optic nerve; Tumors were resected through combined epidural and intradural approach in 14 cases. The effects of surgical methods on tumor resection and visual function recovery were analyzed, and the curative effects of epidural and intradural ACP grinding were compared.

After 3 months of follow-up, the results of MRI showed that: Simpson grade Ⅰ-Ⅱ total resection was performed in 48 cases (76.2%), Simpson Ⅲ-Ⅳ resection in 15 cases (23.8%). The degree of tumor resection was related to whether anterior clinoid grinding and optic canal opening were performed (P<0.05), but there was no obvious relationship with the surgical methods (intradural, extradural, or combination of intradural and extradural) (P>0.05). The postoperative visual acuity level was related to the intraoperative opening of the optic canal (P<0.05), but it has nothing to do with whether ACP was removed or the surgical method (P>0.05).

ACP resection and optic canal opening can improve the rate of total tumor resection, and improve postoperative vision of patients.