title: Surgical implications of frontoethmoidal pneumosinus dilatans-associated proptosis caused by meningioma.
abstract: Pneumosinus dilatans (PSD) involves paranasal sinus enlargement without radiologic evidence of localized bone destruction, hyperostosis, or mucous membrane thickening. We discuss the surgical implications of PSD-associated proptosis in patients with anterior skull-base meningioma. A 20-year-old man with proptosis, hypoglobus, and lateral globe displacement had WHO grade I anterior skull-base and orbital meningiomas. Aggressive resection using anterior/medial orbitotomy and an anterior interhemispheric skull-base approach achieved Simpson grade I resection. Postoperatively, his symptoms improved, with no recurrence at 2-year follow-up. Although PSD-associated proptosis is relatively uncommon, it carries important clinical implications in surgical management of skull-base and orbital meningiomas.
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 North Medical Drive East, Salt Lake City, UT, 84132, USA.
authors.forename: Amol
authors.initials: A
authors.lastname: Raheja
authors.affiliation: College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
authors.forename: Hussam
authors.initials: H
authors.lastname: Abou Al-Shaar
authors.affiliation: Department of Ophthalmology, Moran Eye Center, University of Utah, Salt Lake City, UT, USA.
authors.forename: Bhupendra C
authors.initials: BC
authors.lastname: Patel
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 North Medical Drive East, Salt Lake City, UT, 84132, USA. neuropub@hsc.utah.edu.
authors.forename: William T
authors.initials: WT
authors.lastname: Couldwell
mesh_terms: D005094:Exophthalmos / Q000209:etiology* / Q000601:surgery; D006801:Humans; D015576:Hyperostosis / Q000150:complications / Q000601:surgery*; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications / Q000601:surgery*; D008579:Meningioma / Q000150:complications / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D019291:Skull Base / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
keywords: Anterior skull-base meningioma; Orbital meningioma; Pneumosinus dilatans; Proptosis; Surgical nuances