title: Surgical Management of Extracranial Meningiomas Arising in the Head and Neck.
abstract: OBJECTIVE
  To determine outcomes in the management of extracranial meningiomas of the head and neck.
  
  
  METHODS
  This is a retrospective single-surgeon series performed at a tertiary-care referral center. In all, 23 patients met the inclusion criteria, consisting of 12 men and 11 women. The mean age of patients treated was 60.5 years (range, 32 to 71 years). Subsite involvement included the infratemporal fossa (n = 8), greater wing of the sphenoid and orbit (n = 7), clivus (n = 2), and parapharyngeal space (n = 6).
  
  
  RESULTS
  In all, recurrence occurred in 21% of patients (n = 5) who underwent gross tumor resection. Two patients underwent subtotal resection because of the tumor's location within the clivus with adjuvant CyberKnife therapy (Accuray, Sunnyvale, CA). Both patients had persistent disease with no new neurologic symptoms. Examination showed that 100% of patients (N = 23) had dural involvement. Post-ablative complications occurred in 43% of patients (n = 10).
  
  
  CONCLUSIONS
  We presently report the largest series of surgical treatment for extracranial meningiomas. Gross tumor resection should be the mainstay of therapy, except in anatomically restricted regions such as the petrous apex and clivus. Adjuvant therapy including CyberKnife therapy may be used in such lesions. All lesions showed dural involvement. A more unified nomenclature is required for the characterization of these lesions.
authors.affiliation: Resident Physician, Division of Facial Plastic Surgery, Department of Otolaryngology-Head & Neck Surgery, The New York Eye & Ear Infirmary, New York, NY.
authors.forename: Moustafa
authors.initials: M
authors.lastname: Mourad
authors.affiliation: Fellow Physician, Department of Otolaryngology Head and Neck Surgery, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, TX.
authors.forename: David
authors.initials: D
authors.lastname: Chan
authors.affiliation: Professor, Department of Otolaryngology Head and Neck Surgery, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, TX. Electronic address: yducic@sbcglobal.net.
authors.forename: Yadranko
authors.initials: Y
authors.lastname: Ducic
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D016896:Treatment Outcome