Surgical treatment of Spheno-Orbital Meningiomas
Résumé
Abstract Purpose: To evaluate the outcome of surgery and radiotherapy in the treatment of spheno-orbital meningioma (SOM). Method: A retrospective study of 66 consecutive cases who underwent surgery for SOM with a minimum follow-up of 4 years. Clinical and radiological information was compared before and after the following surgical approaches: frontotemporal craniotomy, frontotemporal craniotomy combined with orbitozygomatic resection, and extended lateral orbitotomy alone. Results: The median age at presentation was 46 (range 26-68) years and the median follow-up after surgery was for 102 (48-288) months. In total, 48 (73%) patients showed preoperative visual deterioration, with visual field defects. All patients had proptosis at presentation with a mean of 6.4±3.0 mm (mean±SD). Surgery for patients with SOM arrests visual deterioration in 61% and improves vision in 30%. Furthermore a substantial reduction of proptosis was achieved in 85% of patients. The proptosis in our group was reduced by 2.6±2.6 mm. There was no correlation between the surgical approach and proptosis reduction (p = 0.125). The recurrence rate was 17%. Only one of 15 patients who underwent radiotherapy showed signs of recurrence. Conclusion: The surgical aim in the treatment of SOM should be the restoration of visual acuity and reduction of proptosis than complete tumour removal. The surgical approach can be tailored to the individual case. We recommend radiotherapy in the sub-totally removed SOM.
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