Article
Management of spheno-orbital meningiomas
Die Behandlung von spheno-orbitalen Meningeomen
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Published: | May 8, 2006 |
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Objective: We present our large series of surgically treated meningiomas en plaque of the sphenoid wing regarding the growth patterns.
Methods: A retrospective analysis was performed on 67 patients (53 f) with meningiomas en plaque originating from the sphenoid wing who underwent surgery between 1991 and 2002.
Results: Total macroscopic resection was achieved in 40 patients. 48 meningiomas extended to the orbital roof and/or lateral orbital wall, 34 involved the extraconal, and 8 even the intraconal space. 54 tumours involved the superior orbital fissure, 46 the optic canal, 21 the inferior orbital fissure. 12 tumours infiltrated the cavernous sinus and 27 involved the anterior clinoid process. There was no mortality, a minor morbidity rate of 11.9% and a major morbidity rate of 3%. Subtotal resections were performed in 27 patients due to intraorbital tumour (n=8), tumour in the cavernous sinus (n=9), tumour beyond the tentorial notch (n=3), tumour invading the superior orbital fissure (n=4), and tumour of the skull base (n=3). 5 patients underwent postoperative 3-dimensional conformal radiotherapy with stable tumour volume at follow-up. Recurrence was found in 7 cases (10.4%) postoperatively (range 13-47 months).
Conclusions: The goal of surgery is complete tumour removal without morbidity. Exact analysis of tumor growth and involvement of different structures is mandatory before performing surgery.