Spheno-Orbital Meningiomas: When the Endoscopic Approach Is Better

Abstract

Spheno-orbital meningiomas were historically treated by traditional craniotomies. However, in the past few years new endoscopic treatments have been successfully performed. In this study, we analyzed different indications for craniotomy and endoscopy, and the advantages and disadvantages of these procedures.Thirty patients with spheno-orbital meningiomas were operated on over 2 years, between 2013 and 2014. Computed tomography (CT) and magnetic resonance imaging (MRI) were performed in all patients preoperatively. Navigated surgical removal and histological confirmation, as well as follow-up examinations, including CT scan at 24 h and MRI at 3, 6, and 12 months after surgery, were performed. Twenty-three patients were treated by traditional fronto-temporal, fronto-temporo-orbital, and supraorbital craniotomies; in six cases the tumor was removed via endoscopic endonasal and lateral transorbital resection. Only one case required a combined supraorbital and endoscopic endonasal approach.We analyzed the results of the different surgical techniques, in particular those of the endoscopic approaches.In selected cases, the endoscopic approach to spheno-orbital meningiomas, compared with traditional approaches, may be more effective in removing tumors completely. The surgical technique is easy and the rate of complications is low.

Exclusively endoscopic endonasal resection of benign orbital tumors: a systematic review and meta‐analysis

“…and A.E.L. ), a final list of articles was generated for data collection (see Supplementary Table 2) 1,3,7,8,17,20–50 …”

Surgery around the Orbit: How to Select an Approach

“…The transorbital approach is the preferred approach for treatment of spheno-orbital meningiomas. 8 Those extraaxial tumors arise from the sphenoid ridge and may extend laterally into the temporal bone, medially into the cavernous sinus, and anteriorly to the orbit. They can also invade the dura of the fronto-orbital and temporo-sphenoidal region, and are responsible for various degrees of hyperostosis.…”

The Role of the Transorbital Superior Eyelid Approach in the Management of Selected Spheno-orbital Meningiomas: In-Depth Analysis of Indications, Technique, and Outcomes from the Study of a Cohort of 35 Patients

“…Although the primary goal remains the complete removal of the lesion along with its dural and osseous parts, it is nowadays accepted to aim for maximally safe STR, trying to preserve patient quality of life. 1,6,11,18,19 Typically, these tumors are addressed through classical frontotemporal craniotomies, such as the pterional and orbitozygomatic variants. 2 Along with the recent evolution of minimally invasive techniques to manage skull base lesions, in the last years the endoscopic superior eyelid transorbital corridor was proposed to manage orbital lesions laterally placed to the optic nerve.…”