Orbitosphenoid Meningiomas

Sincoff, Eric H.; Delashaw, Johnny B.

doi:10.1007/978-1-84628-784-8_40

Cited by 1 publication

(2 citation statements)

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“…Sex distribution in our series was 31 men and 57 women (M/F ratio of 1/1.8), which are remarkably different from other reports showing ratios between 1/3 and 1/15 with an average of 1/3 to 5. [ 11 20 21 32 39 44 46 ] We encountered only one similar report from China[ 26 ] with M/F ratio of 1/1.5. That might suggest that women with minimal symptomatology, that is, only asymmetric eyes and bulging of the temporal region, which can be covered easily by the hair or scarf, come very late or even never for medical consultation.…”

Section: Discussionmentioning

confidence: 99%

“…The diploic component of the hyperostotic bone had nonspecific characteristics both in CT scans and MRI that could not match the histopathologic findings in our cases, which is also suggested by others. [ 9 11 22 28 32 43 44 45 46 ] We tried to tabulate the type of tumor infiltration of the adjacent hyperostotic bone to ‘ high ’, ‘ medium ’, and ‘ no ’ infiltration according the different samples taken during surgery and submitted separately for histopathological examination but the differences were not of significance [ Table 3 ].…”

Section: Discussionmentioning

confidence: 99%

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Lateral orbitotomy approach for removing hyperostosing en plaque sphenoid wing meningiomas. Description of surgical strategy and analysis of findings in a series of 88 patients with long-term follow up

Amirjamshidi

Abbasioun²,

Amiri

et al. 2015

Surg Neurol Int

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Background:Sphenoid wing meningiomas extending to the orbit (ePMSW) are currently removed through several transcranial approaches. Presenting the largest surgical cohort of hyperostosing ePMSW with the longest follow up period, we will provide data supporting minilateral orbitotomy with excellent exposure for wide resection of all compartments of the tumor.Methods:A retrospective survival analysis is made of the data cumulated prospectively during a period of 34 years, including 88 cases of ePMSW with a mean follow up period of 136.4 months. The impact of preoperative variables upon different outcome measures is evaluated. Standard pterional craniotomy was performed in 12 patients (C) while the other 76 cases underwent the proposed modified lateral miniorbitotomy (LO).Results:There were 31 men and 57 women. The age range varied between 12 and 70 years. Patients presented with unilateral exophthalmos (Uex) ranging between 3 and 16 mm. Duration of proptosis before operation varied between 6 months and 16 years. The status of visual acuity (VA) prior to operation was: no light perception (NLP) in 16, light perception (LP) up to 0.2 in 3, 0.3–0.5 in 22, 0.6–0.9 in 24, and full vision in 23 patients. Postoperatively, acceptable cosmetic appearance of the eyes was seen in 38 cases and in 46 mild inequality of < 2 mm was detected. Four cases had mild enophthalmos (En). Among those who had the worst VA, two improved and one became almost blind after operation. The cases with VA in the range of 0.3–0.5 improved. Among those with good VA (0.5 to full vision), 2 became blind, vision diminished in 10, and improved or remained full in the other 35 cases. Tumor recurrence occurred in 33.3% of group C and 10.5% of group LO (P = 0.05). The major determinant of tumor regrowth was the technique of LO (P = 0.008).Conclusion:Using LO technique, the risky corners involved by the tumor is visualized from the latero-inferior side rather than from the latero-superior avenue. This is the crucial milestone to achieve aggressive removal of all the involved compartments of the lesion. Satisfactory cosmetic result is reported using mini LO technique after widely exposing and removing the hyperostotic bone down to the subtemporal fossa with only simple repair of the dura without cranioplasty.

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