gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Case series of sphenoorbital meningiomas: Presentation, surgical outcome, complications, pitfalls

Meeting Abstract

  • R.B. Moringlane - Abteilung für Neurochirurgie, Universitätsklinikum Göttingen
  • K.V. Eckardstein - Abteilung für Neurochirurgie, Universitätsklinikum Göttingen
  • V. Rohde - Abteilung für Neurochirurgie, Universitätsklinikum Göttingen

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocSA.03.11

DOI: 10.3205/12dgnc331, URN: urn:nbn:de:0183-12dgnc3313

Published: June 4, 2012

© 2012 Moringlane et al.
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Outline

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Objective: Sphenoorbital meningiomas are a rare subgroup of meningiomas of the sphenoid wing infiltrating the orbit and thus putting vision at risk. Because of limited resectability these tumors pose a challenge for surgical treatment. Larger mono-institutional series with consistent surgical strategies over years still are infrequent, which encouraged us to report a series of 28 patients, focusing on pre- and postoperative status and outcome. Emphasis is place on complications.

Methods: We performed a retrospective chart review of patients undergoing surgery for sphenoorbital meningioma in our institution. Charts were evaluated for pre- and postoperative proptosis and visual acuity, complications, and extent of resection.

Results: A total of 28 patients with a sphenoorbital meningioma were surgically treated (25 female, 3 men). Age ranged from 45 to 75 years. Proptosis was present preoperatively in 27 patients. After surgery, only 3 patients had persistent proptosis. Decreased visual acuity was found in 17 patients before surgery, which improved after surgery in 8. Surgery-associated complication occurred in 9 patients (CSF fistula in 4, successfully treated by lumbar drainage, oculomotor palsy in 3, ophthalmoplegia in 1, deterioration of visual acuity in 1). MRI on follow-up visits verified a complete resection in 15 patients.

Conclusions: Complete resection was only possible in 53% of cases. This was due to widespread infiltration into base of the middle fossa, reaching the canal of the carotid artery and the sphenoidal sinus, and due to tumor growth into the cavernous sinus. Despite incomplete resection, surgery remains highly effective in improving proptosis and decreased visual acuity and has to be the first treatment option. Permanent surgery-related neurological deficits are rare and are exclusively focused on cranial nerve dysfunction.