Artikel
Spheno-orbital meningiomas: interdisciplinary surgical approach, resectability and long-term results
Spheno-orbitale Meningeome: interdisziplinäre operative Behandlung, Resektionsrate und Langzeitergebnisse
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
To describe our interdisciplinary surgical approach in spheno-orbital meningiomas (SOM) and to evaluate the operative results with respect to resectability and functional outcome.
Methods
A series of 16 patients underwent surgical resection of SOM with following bony reconstruction. Four patients presented with a recurrent SOM and had undergone surgical resection previously. Radical tumor removal was attempted in all cases, whereas no aggressive effort was made to remove tumor infiltrating the cavernous sinus or deep orbital soft tissues in order to avoid severe functional disturbances. All patients but one were female (mean age 53 years). Mean follow-up period was 68 months.
Results
Leading symptom was proptosis in 14 patients, in 7 cases accompanied by progressive visual impairment. Surgical resection was complete in 11 patients (68.7%) and incomplete in 5 (31.3%). Residual tumour was deliberately left due to infiltration in the cavernous sinus (n=4), the pterygopalatine fossa (n=2) and the deep intraorbital soft tissues (n=1). Tumour recurrence was observed in 9 patients, among these were 6 patients with an initially complete resected SOM. Eight patients underwent reoperation. Complete resection was achieved in 3 of these patients with an exclusively isolated intraorbital tumour manifestation.
Conclusions
By means of combined skull base approaches, SOMs can be completely resected with long-term recurrence-free survival and an acceptable quality of life. In some cases, deliberate subtotal tumour resection is useful to avoid severe neurological damage with sufficient tumour control and a valuable progression-free survival.