title: Surgical strategies for the removal of sphenoorbital meningiomas.
abstract: OBJECTIVE
  Surgical removal of sphenoorbital meningiomas is challenging for neurosurgeons. The aim of study is to share our experience on sphenoorbital meningiomas and to provide a picture of the current state of the art in surgical treatment of these tumors.
  
  
  METHODS
  The data of 13 cases of sphenoorbital meningioma who were operated between 2006 and 2013 was reviewed retrospectively. Intraorbital extension was present in 10 cases while sphenoid bone invasion was detected in 9 cases. All patients underwent surgical treatment after the radiological evaluation with magnetic resonance imaging and computed tomography. The degree of resection and the clinical outcome of all patients were analyzed.
  
  
  RESULTS
  Extended pterional approach with a large frontotemporal craniotomy was performed in all cases. Simpson's grade I and II excision was achieved in 4 (31%) cases while subtotal excision (Simpson's grade III or higher) was performed in 9 cases. The main reason for subtotal excision was the cavernous sinus invasion. Optic canal decompression was performed in patients with intraorbital invasion.
  
  
  CONCLUSIONS
  Although total removal is the main objective of surgery, the sphenoorbital meningiomas are difficult to resect especially with cavernous sinus invasion. But in the meantime, it is not recommended to take any excessive risks to achieve a greater degree of resection for a benign tumor. Endoscopic approach is an option for inferomedial orbital parts of these tumors.
authors.affiliation: Gulhane Military Medical Academy, Department of Neurosurgery, Ankara, Turkey.
authors.forename: Ilker
authors.initials: I
authors.lastname: Solmaz
authors.forename: Ozkan
authors.initials: O
authors.lastname: Tehli
authors.forename: Caglar
authors.initials: C
authors.lastname: Temiz
authors.forename: Cahit
authors.initials: C
authors.lastname: Kural
authors.forename: Irgen
authors.initials: I
authors.lastname: Hodaj
authors.forename: Murat
authors.initials: M
authors.lastname: Kutlay
authors.forename: Engin
authors.initials: E
authors.lastname: Gonul
authors.forename: Mehmet K
authors.initials: MK
authors.lastname: Daneyemez
mesh_terms: D000328:Adult; D002426:Cavernous Sinus / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D009918:Orbital Neoplasms / Q000601:surgery*; D013100:Sphenoid Bone / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome