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56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Spheno-orbital meningiomas : surgical technique and outcome

Spheno-orbitale Meningeome: Operative Technik und Outcome

Meeting Abstract

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  • corresponding author F. Ringel - Neurochirurgische Kliniken, Universitätsklinikum Bonn
  • C. Cedzich - Neurochirurgische Kliniken, Klinikum Nürnberg
  • J. Schramm - Neurochirurgische Kliniken, Universitätsklinikum Bonn

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-05.03

The electronic version of this article is the complete one and can be found online at:

Published: May 4, 2005

© 2005 Ringel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




Intraosseus meningiomas of the base of the anterior and middle cranial fossa involving the sphenoid wing and orbit are a rare form of meningioma growth. Literature refers to terms as meningioma en plaque, intraosseus meningioma or sphenoorbital meningioma (SOM). The present study describes a surgical series of 65 such tumours.


Charts of patients operated for SOM by or under supervision of the senior author at the Neurosurgical Departments of the University of Erlangen and Bonn were retrospectively reviewed for presenting symptoms, surgical technique and clinical outcome.


Between 1983-89 (Erlangen) and 1989-2003 (Bonn) 65 patients (mean age 51±11 years, range 21-77, 52 female, 13 male) were surgically treated in 76 procedures. The most common symptoms were proptosis (n=44), visual deficits (n=17), and pterional soft tissue swelling (n=17). 21 pts had visual field deficits, 26 pts a visual acuity <0.6. Other cranial nerve palsies were present in 17 pts (6 Cr.N. III, 5 IV, 2 V, 2 VI, 2 VII, 6 double vision). Three patients presented with bilateral tumours. In 65 cases the lesser sphenoid wing was largely resected, the lateral orbital wall was resected in 56 cases, the orbital roof in 63, and optic canal decompression was performed in 45 cases. Periorbital tumour infiltration lead to intraorbital resection in 34 cases, 4 cases presented a solid intraorbital tumour. The middle fossa base was resected in 46 cases. 57 cases were associated with a dural involvement, 14 pterional bone flaps were tumour-infiltrated. Median follow-up is 4.5 years (range 0-17). 26 patients showed stable tumour residuals, 14 progressive tumour rests. 1 patient presented with a contralateral tumour recurrence. 11 were operated for recurrent meningiomas, 4 treated by radiation therapy. 12 pts. showed temporary oculomotor deficits, 8 permanent. Temporary ptosis was observed in 9 cases, persisting in 2. Two pts showed new Cr.N. V deficits.


SOM are rare tumours. Since involvement of delicate structures of the orbital cone is common, complete surgical resection is frequently impossible. Some persisting neurological deficits are possible, whereas proptosis and other visual deficits are usually relieved. Two thirds of tumour rests remained stable during follow-up. Consequently, aim should be the relief of leading symptoms in contrast to radical resection.