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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

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Spheno-orbital meningiomas: interdisciplinary surgical approach, resectability and long-term results

Spheno-orbitale Meningeome: interdisziplinäre operative Behandlung, Resektionsrate und Langzeitergebnisse

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  • corresponding author I. E. Sandalcioglu - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Essen
  • T. Gasser - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Essen
  • C. Mohr - Klinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinikum Essen
  • D. Stolke - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Essen
  • H. Wiedemayer - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Essen

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. DocP200

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0468.shtml

Published: May 4, 2005

© 2005 Sandalcioglu et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

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.