Surgical treatment of spheno - orbital meningiomas: a clinical review of 18 cases

Abstract

Objective To investigate the effect and follow - up outcome of transcranial approach for spheno - orbital meningiomas.Method Eighteen cases of spheno - orbital meningiomas were removed through different transcranial approaches including frontal - temporal ( pterional and modified pterional ) approach ( 15 cases),orbital -zygomatic approach( 2 cases) and orbital -zygomatic combined with extended transbifrontal approach( 1 case).The involved sphenoid wing and peri -orbit bone were removed to prevent recurrence.The superior orbital fissure and optic canal were decompressed.The visual function evaluation was performed.The extent of tumor resection was judged by intraoperative finding and postoperative image examination.Results The extent of tumor resection:2 cases were Simpson Grade Ⅰ,6 Grade Ⅱ,8 Grade Ⅲ and 2 Grade Ⅳ.After surgery,proptosis was improved in all patients.Visual function was improved in 13 cases.There was no operation - related death.Tumor recurrence was found in 2 cases.Conclusions Adequate exposure of tumor and bony decompression of related cranial nerves could be achieved from appropriate transcranial approaches,thus could relieve clinical symptoms such as proptosis,visual function disturbance and ocular motor malfunction.Complete surgical resection is difficult to be achieved because of involvement of orbital apex,superior orbital fissure and cavernous sinus. Key words: Meningioma; Microsurgery; Clinical