Combination of Surgery and Gamma Knife in the Management of En Plaque Meningioma

Abstract

Objective: The aim of this study was to determine the results of using gamma knife in resection of en plaque meningioma after subtotal surgery resection.Materials and Methods: All patients with en plaque meningioma in spheno-orbital area, who were subject to this experiment in the Neurosurgery Clinic of Shahid Rajai Hospital (affiliated to Qazvin University of Medical Sciences, Qazvin, Iran), were operated for tumor resection. Gamma knife was used to resect the tumor tissue in patients who underwent subtotal surgery resection. Patients were followed up for recurrence.Results: Of the 22 patients with average age of 53.82 ± 11.03 years who participated in this study, 7 (31.82%) were male and 15 (68.18%) were female. Proptosis was the prevalent symptom with 77.28% prevalence. Tumor tissue was totally resected in 6 patients (26.1%), and the remaining patients were treated by gamma knife after undergoing subtotal resection. Visual acuity, tumor size, and the distance between the interzygomatic line and the interior surface of the eyeball had significant improvement after 3 months (P-value of changes of all 3 variables was <0.001). Recurrence in 6 patients (27.27%) was diagnosed on average 41.18 ± 5.77 months after follow-up, and it was significantly lower in patients treated using gamma knife (P-value <0.01). Recurrence was caused by involvement of orbital cavity and cavernous sinus (P-value < 0.01).Conclusions: Using gamma knife is useful in the treatment of en plaque meningioma patients after undergoing subtotal surgery resection. It also reduces the risk of tumor recurrence.