Clinical Outcome of Surgical Excision of Spheno-Orbital Meningiomas: Local Experience

Abstract
Background: Spheno-orbital meningiomas are considered as tumors involving the sphenoid wing, orbit, and cavernous sinus. Their complete surgical resection is difficult. Sphenoidal hyperostosis that results in incomplete resection makes these tumors prone to high rates of recurrence.
Aim of Study: The aim of this retrospective study was to investigate the outcome of twelve consecutive patients treated by microsurgical resection of spheno-orbital meningiomas.
Patients and Methods: This series consisted of twelve patients who were retrospectively analyzed over a 5-year period. Visual function was evaluated pre-and post-operatively in all patients. We used a standardized surgical approach through supraorbital-pterional approach with drilling of all sphenoidal hyperostotic bone. Surgical outcome, complications and recurrence were clarified.
Results: There were two men and ten women included in the study, with a mean age of 50.8 years (range 27-63 years). Pre-operative symptoms include proptosis (67%), blurred vision (58%) and diplopia. All patients underwent microsur-gical resection through supraorbital-pterional approach. An excellent clinical result was observed in six patients. Recur-rence was evident in four patients.
Conclusions: Spheno-orbital meningiomas are character-ized by potentially extensive hyperostosis of the skull base. Successful resection necessitates drilling of the superior orbital fissure and orbital osteotomy within anatomical limitations. Complete resection was found to be limited by tumor remaining in the cavernous sinus and the optic canal.