Abstract

IntroductionSpheno-orbital meningiomas are characterized by bone invasion with extensive hyperostosis and possible encroachment into the orbit, infra-temporal fossa, and/or the cavernous sinus that render total surgical excision challenging. The surgical technique utilized is a key factor facilitating complete resection and hence improvement of proptosis and accompanying visual symptoms.MethodsThis is a retrospective study of twenty-two patients (including 4 recurrent cases) with meningioma en-plaque, presenting with hyperostosis and proptosis. We describe the surgical approaches used, technique, and extent of resection in addition to postoperative outcome.ResultsIn twenty patients, the pterional approach was used, while two patients were operated on via the mini orbito-zygomatic approach. Total resection of the tumor was achieved in 10 cases (45.5%), subtotal in 6 (27.3%), partial in 5 (22.7%), and in 1 case, injury to the internal carotid artery lead to premature termination of surgery. Seventeen patients (77.3%) had improvement of proptosis, 2 (9.1%) had partial improvement, and 2 (9.1%) had no improvement at 3 months of follow-up. Post-operative morbidities include cerebrospinal fluid leak, infection, and hydrocephalus, each occurred in one (4.5%) different case.ConclusionsProper drilling of the lateral and superior orbital walls with excision of any intra-orbital soft tissue components is all key points for better surgical resection and clinical regression of proptosis. However, factors such as extension of the hyperostosis to the infra-temporal fossa or medial orbital wall, tumor invasion of the cavernous sinus, or adherence of tumor to the orbital muscles, prevent total excision.

Highlights

  • Spheno-orbital meningiomas are characterized by bone invasion with extensive hyperostosis and possible encroachment into the orbit, infra-temporal fossa, and/or the cavernous sinus that render total surgical excision challenging

  • Spheno-orbital meningiomas (SOM) represent a subgroup of sphenoid ridge meningiomas that are known as the en-plaque meningiomas account for 20% of intracranial meningiomas [1]

  • We retrospectively studied and evaluated twenty-two patients with spheno-orbital meningiomas presenting with proptosis who underwent surgical resection

Read more

Summary

Introduction

Spheno-orbital meningiomas are characterized by bone invasion with extensive hyperostosis and possible encroachment into the orbit, infra-temporal fossa, and/or the cavernous sinus that render total surgical excision challenging. The surgical technique utilized is a key factor facilitating complete resection and improvement of proptosis and accompanying visual symptoms. Spheno-orbital meningiomas (SOM) represent a subgroup of sphenoid ridge meningiomas that are known as the en-plaque meningiomas account for 20% of intracranial meningiomas [1]. This location is considered to be the third most common location for meningiomas [2, 3]. Enplaque meningiomas with extension into the orbit represent only 2‐9% of meningiomas [4,5,6]. The main presenting symptoms are proptosis, visual impairment, and not uncommonly retro-orbital pain. Patients with recurrence of SOMs usually present with optic nerve involvement [3]

Methods
Results
Discussion
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call