Spheno-orbital meningiomas: Is orbit reconstruction mandatory? Long-term outcomes and exophthalmos improvement.

Autor:	Dos Santos AG; Division of Neurosurgery, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, Brazil., Paiva WS; Division of Neurosurgery, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, Brazil., da Roz LM; Division of Neurosurgery, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, Brazil., Santo MPDE; Division of Neurosurgery, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, Brazil., Teixeira MJ; Division of Neurosurgery, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, Brazil., Figueiredo EG; Division of Neurosurgery, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, Brazil., da Silva VTG; Division of Neurosurgery, Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Surgical neurology international [Surg Neurol Int] 2022 Jul 22; Vol. 13, pp. 318. Date of Electronic Publication: 2022 Jul 22 (Print Publication: 2022).
DOI:	10.25259/SNI_165_2022
Abstrakt:	Background: Meningiomas correspond to one-third of all primary central nervous system tumors. Approximately 9% of them are spheno-orbital meningiomas (SOMs), presenting significant clinical symptoms as visual impairment and orbital esthetics. This article aims to evaluate exophthalmos' improvement in a surgical series without orbital reconstruction. Methods: We consecutively included all patients diagnosed with SOM, admitted to a single institution for 10 years. Surgical resection was the standard of care, associated or not with adjuvant radiation therapy. The radiological investigation included preoperative and postoperative head CT or MRI. We quantified proptosis through imaging. Results: Forty patients composed this series, 87.5% were female. Proptosis was the most common presentation (90%), followed by decreased visual acuity (65%), motility deficit (20%), and headache (20%). Gross total resection was achieved in 65% of the procedures. In late outcomes, 78% of the patients maintained or improved visual acuity and 85% maintained or improved headache. Proptosis significantly improved after surgery and along with the follow-up ( P < 0.001). Ten patients were submitted to adjuvant RT, six of them after a subtotal resection. All patients of this subgroup had proptosis. It was observed a higher frequency of worse in visual acuity in patients submitted to RT (71% vs. 28%, P = 0.038). Conclusion: Resection of SOM was sufficient to stop the evolution of visual deficit and allowed the improvement of proptosis. Orbital reconstruction does not seem to be an essential step in reducing enophthalmos. Competing Interests: There are no conflicts of interest. (Copyright: © 2022 Surgical Neurology International.)
Databáze:	MEDLINE
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