Sphenoorbital Meningiomas

Abstract

Introduction: Sphenoorbital meningiomas (SOM) are defined as dominant intraosseous meningiomas of the sphenoid wing, the roof and the lateral wall of the orbit associated with an only an “en plaque” intracranial component. The tumors usually involve the anterior clinoid process, the superior orbital fissure, the optic canal, and the sphenoid or ethmoidal sinuses. Material and Methods: A series of 29 patients, with SOM was managed from 2000 to 2013. A total of 23 patients (including 5 recurrences) underwent operation. Results: The median follow-up period was 8 years. Around 48% of patients had tumor residuals (orbital apex, superior orbital fissure, cavernous sinus). Out of these residual tumors two patients (20%) had significant progression. Proptosis improved in all patients, 43% of the patients had improved visual acuity. Postoperatively, nine patients showed a temporary cranial nerve deficit and one patient showed permanent deficit. No new limiting diplopia occurred after surgery and surgical mortality was zero. Conclusion: Radical resection of SOM is frequently impossible because of the involvement of important structures in the region of the orbital apex and the cavernous sinus. The goal of the surgery is to relief the symptoms (proptosis, diplopia, visual acuity deterioration) with preservation of all neurological functions and excellent cosmetic reconstruction.