MNGI-01. SURGICAL RESECTION AND ORBITAL RECONSTRUCTION IN SPHENO-ORBITAL MENINGIOMAS. (5th November 2018)

• Record Type: Journal Article
• Authors: Kwon, Churl-Su; Al-Awar, Omar
• Is Part Of: Neuro-oncology. Volume 20(2018)Supplement 6
• Page Start: vi148
• Page End: vi148
• Publication Date: 2018-11-05
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noy148.617
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: OBJECTIVE: To describe surgical technique and outcomes of surgical resection of intracranial, intra-orbital and intra-osseous disease in spheno-orbital meningiomas (SOMs) with periorbital and bony orbit reconstruction. METHODS: We performed a single institution retrospective review of consecutive cases between 2005 and 2016. Meningioma pathology records of 1007 patients revealed 125 sphenoid meningiomas of which 32 patients met eligibility criteria for SOMs. Clinical findings, radiographic features, operative technique, outcomes and follow-up data are presented. RESULTS: Of the 32 patients 20 met inclusion criteria. Mean follow-up duration was 69 months. The mean age of patients was 55 (range 32–82) with a female predominance (16F:4M). 4 (20%) had vascular involvement and 12 (60%) cavernous sinus infiltration. 9 (45%) tumors extended medially to the foramen rotundum and ovale. 8 (40%) patients did not require a bony orbital reconstruction, 11 (55%) had a split calvarial bone graft and 1 (5%) patient had a temporalis muscle graft. In 19 (95%) patients, pericranium was used for reconstruction of the peri-orbita and dura. 8 (40%) patients had complete clearance of their orbital disease. All patients presented with proptosis and in the majority this was corrected. 17 (85%) patients had WHO grade I disease with the other 3 (15%) WHO grade II disease. Of the 13 patients who had visual impairment, 9 patients had improved vision postoperatively, including 3 patients whose vision returned to normal. CONCLUSION: The management of SOM remains challenging for both resection and reconstruction. The goals of surgery entail recovery of compromised CN function and long-term tumor control. A multidisciplinary approach allows for safe resection with improvement in cosmesis. The benefits of orbital reconstruction are: structural, cosmetic, and provide landmarks for postoperative imaging.