Surgical treatment of sphenoorbital meningiomas.
OBJECTIVE
To evaluate the outcome of surgery and radiotherapy in the treatment of sphenoorbital meningioma (SOM).


METHODS
A retrospective study of 66 consecutive cases treated with surgery for SOM with a minimum follow-up of 4 years. Clinical and radiological information were 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 years (range, 26-68 years) and the median follow-up after surgery was 102 months (range, 48-288 months). In total, 48 (73%) patients showed preoperative visual deterioration, with visual field defects. All patients had proptosis at presentation (mean ± SD=6.4 ± 3.0 mm). Surgery for patients with SOM arrested visual deterioration in 61% and improved vision in 30% of cases. Furthermore, a substantial reduction of proptosis was achieved in 85% of patients. The proptosis in this group was reduced by 2.6 ± 2.6 mm. There was no correlation between surgical approach and proptosis reduction (p = 0.125). The recurrence rate was 17%. Only 1 out of 15 patients who underwent radiotherapy showed signs of recurrence.


CONCLUSIONS
The surgical aims in the treatment of SOM should be the restoration of visual acuity and reduction of proptosis, rather than complete tumour removal. The surgical approach can be tailored to individual cases. The authors recommend radiotherapy in cases of subtotally removed SOM.
Orbital Center of Academic Medical Center, Department of Ophthalmology, University of Amsterdam, Amsterdam, The Netherlands. p.saeed@amc.uva.nl
Peerooz
P
Saeed
Wouter R
WR
van Furth
Michael
M
Tanck
Nicole
N
Freling
Jan Willem Berkelbach
JW
van der Sprenkel
Lukas J A
LJ
Stalpers
Jacobus J
JJ
van Overbeeke
Maarten P
MP
Mourits
D000328:Adult; D000368:Aged; D003399:Craniotomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013100:Sphenoid Bone / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*