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Original article
Surgical treatment of sphenoorbital meningiomas
  1. Peerooz Saeed1,
  2. Wouter R van Furth2,
  3. Michael Tanck3,
  4. Nicole Freling4,
  5. Jan Willem Berkelbach van der Sprenkel5,
  6. Lukas J A Stalpers6,
  7. Jacobus J van Overbeeke7,
  8. Maarten P Mourits1
  1. 1Orbital Center of Academic Medical Center, Department of Ophthalmology, University of Amsterdam, Amsterdam, The Netherlands
  2. 2Department of Neurosurgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  3. 3Department of Epidemiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  4. 4Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  5. 5Department of Neurosurgery, University Medical Center, Utrecht, The Netherlands
  6. 6Department of Radiotherapy, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  7. 7Department of Neurosurgery, University Medical Centre, Maastricht, The Netherlands
  1. Correspondence to Dr Peerooz Saeed, Orbital Center of Academic Medical Center, Department of Ophthalmology, University of Amsterdam, PO. Box 22660, 1100 DD Amsterdam, The Netherlands; p.saeed{at}amc.uva.nl

Abstract

Aim To evaluate the outcome of surgery and radiotherapy in the treatment of sphenoorbital meningioma (SOM).

Method A retrospective study of 66 consecutive cases treated with surgery for SOM with a minimum follow-up of 4 years. Clinical and radiological information were compared before and after the following surgical approaches: frontotemporal craniotomy, frontotemporal craniotomy combined with orbitozygomatic resection and extended lateral orbitotomy alone.

Results The median age at presentation was 46 years (range, 26–68 years) and the median follow-up after surgery was 102 months (range, 48–288 months). In total, 48 (73%) patients showed preoperative visual deterioration, with visual field defects. All patients had proptosis at presentation (mean±SD=6.4±3.0 mm). Surgery for patients with SOM arrested visual deterioration in 61% and improved vision in 30% of cases. Furthermore, a substantial reduction of proptosis was achieved in 85% of patients. The proptosis in this group was reduced by 2.6±2.6 mm. There was no correlation between surgical approach and proptosis reduction (p=0.125). The recurrence rate was 17%. Only 1 out of 15 patients who underwent radiotherapy showed signs of recurrence.

Conclusions The surgical aims in the treatment of SOM should be the restoration of visual acuity and reduction of proptosis, rather than complete tumour removal. The surgical approach can be tailored to individual cases. The authors recommend radiotherapy in cases of subtotally removed SOM.

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Footnotes

  • Funding None.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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