Spheno-orbital meningiomas: interdisciplinary surgical approach, resectability and long-term results
| Autor: | Christopher Mohr, Dietmar Stolke, Helmut Wiedemayer, I. Erol Sandalcioglu, Thomas Gasser |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Reoperation Reconstructive surgery medicine.medical_specialty Sphenoid bone Meningioma Sphenoid Bone Meningeal Neoplasms medicine Exophthalmos Humans Sphenoorbital Meningioma Aged Pterygopalatine fossa business.industry Soft tissue Middle Aged medicine.disease Surgery Treatment Outcome medicine.anatomical_structure ddc: 610 Otorhinolaryngology Cavernous sinus Orbital Neoplasms Female Dura Mater Neoplasm Recurrence Local Oral Surgery business Recurrent Meningioma |
| Zdroj: | 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC); 20050507-20050511; Strasbourg; DOCP200 /20050504/ |
| ISSN: | 1010-5182 |
| DOI: | 10.1016/j.jcms.2005.01.013 |
| Popis: | Summary Objective To describe the interdisciplinary surgical approach in spheno-orbital meningiomas and to evaluate the operative results regarding resectability and functional outcome. Patients and methods A series of 16 patients underwent surgical resection of spheno-orbital meningiomas followed by bony reconstruction. Four patients presented with a recurrent meningioma and had undergone surgical resection previously. Radical tumour removal was attempted in all cases, although no aggressive effort was made to remove tumour tissue infiltrating the cavernous sinus or soft tissues deep in the orbit to avoid severe functional disturbances. All patients but one were female (mean age 53 years). Mean follow-up period was 68 months (range 4–155 months). Results The leading symptom was proptosis in 14 patients, accompanied in 7 cases by progressive visual impairment. Surgical resection was thought to have been complete in 11 patients (69%) and incomplete in 5 (31%). Residual tumour was deliberately left when there was infiltration of the cavernous sinus \( n = 4 \) , the pterygopalatine fossa \( n = 2 \) and/or the deep intraorbital soft tissues \( n = 1 \) . Tumour recurrence was observed in 9 patients, among whom were 6 patients with an initially "completely" resected meningioma. Eight patients underwent re-operation. Complete resection was achieved in 3 of these latter patients with an isolated exclusively intraorbital tumour manifestation. Conclusion By means of combined skull base approaches, spheno-orbital meningiomas are grossly resected totally with a long-term survival free of recurrence 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. |
| Databáze: | OpenAIRE |
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