Internal and external spheno-orbital meningioma varieties: different outcomes and prognoses

Leroy, Henri‐Arthur; Leroy-Ciocanea, Cristina Ioana; Baroncini, Marc; Bourgeois, Philippe; Pellerin, P.; Labreuche, Julien; Duhamel, Alain; Lejeune, Jean‐Paul

doi:10.1007/s00701-016-2850-0

Cited by 32 publications

(27 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The primary goal of reconstruction of the orbital walls is to prevent enophthalmos, especially pulsatile enophthalmos, which after reconstruction occurs between 2,3% and 30,0% of patients (Gaillard et al 1997; Honeybul et al 2001; Bikmaz et al 2007; Ringel et al 2007; Mirone et al 2009; Saeed et al 2011; Amirjamshidi et al 2015; Terrier et al 2018). Reconstruction of dural defects is done to prevent CSF leaks, and reduce the risk of wound infection and meningitis (Talacchi et al 2014; Leroy et al 2016), which after reconstruction occurs in respectively 5%, 3% and 6% of patients. The periorbit can be opened or removed to gain access to intra‐orbital tumour extension.…”

Section: Discussionmentioning

confidence: 99%

“…Meningiomas are central nervous system tumours, arising from the meninges (Whittle et al 2004). Spheno‐orbital meningiomas (SOM) represent 9–18% of all meningiomas (Cushing & Eisenhardt 1939; Maroon et al 1994; Mirone et al 2009; Leroy et al 2016) and are characterized by substantial hyperostosis of the sphenoid wing with an en‐plaque carpet‐like soft‐tissue component (Li et al 2009). Due to the complex anatomical location in the anterior skull base and the tendency for invasion of the periorbit, intra‐orbital growth, and sometimes the extensive hyperostosis of the optic canal, superior orbital fissure, and other cranial nerve foramina, resection of these tumours is challenging and is associated with possible neurological and visual deficits (Ringel et al 2007).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Surgery as a safe and effective treatment option for spheno‐orbital meningioma: a systematic review and meta‐analysis of surgical techniques and outcomes

Fisher

Najafabadi

Schoones

et al. 2020

Acta Ophthalmologica

View full text Add to dashboard Cite

Purpose The effectiveness and safety of surgery for spheno‐orbital meningiomas remains subject of debate, as studies often describe different surgical approaches and reconstruction techniques with very heterogeneous outcomes. We aimed to systematically summarize and analyse the literature on spheno‐orbital meningiomas regarding presenting symptoms, surgical techniques, outcomes and complications. Methods Studies were retrieved from eight databases. Original articles were included if in ≥5 patients presenting symptoms, surgical treatment and outcomes were described. Fixed‐ and random‐effects meta‐analysis was performed to estimate weighted percentages with 95%CIs of presenting symptoms, outcomes and complications. Results Thirty‐eight articles were included describing 1486 patients. Proptosis was the most common presenting symptom (84%; 95%CI 76–91%), followed by unilateral visual acuity deficits (46%; 95%CI 40–51%) and visual field deficits (31%; 95%CI 20–43%). In 35/38 studies (92%), a pterional craniotomy was used. Decompression of the optic canal (82%) and the superior orbital fissure (66%) was most often performed, and usually dural (47%) and bony defects (76%) were reconstructed. In almost all patients, visual acuity (91%; 95%CI 86–96%), visual fields (87%; 95%CI 70–99%) and proptosis (96%; 95%CI 90–100%) improved. Furthermore, surgery showed improvement in 96% (95%CI 78–100%) for both diplopia and ophthalmoplegia. The most common surgical complications were hypesthesia (19%; 95%CI 10–30%), ptosis and diplopia (both 17%; 95%CI, respectively, 10–26% and 5–33%) and ophthalmoplegia (16%; 95%CI 10–24). Conclusion Patients with spheno‐orbital meningioma usually present with proptosis or unilateral decreased visual acuity. Surgery shows to be effective in improving visual acuity and visual field deficits with mostly minor and well‐tolerated complications.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Surgery as a safe and effective treatment option for spheno‐orbital meningioma: a systematic review and meta‐analysis of surgical techniques and outcomes

Fisher

Najafabadi

Schoones

et al. 2020

Acta Ophthalmologica

View full text Add to dashboard Cite

show abstract

“…Histological sampling was done in 14 of these patients and 10 of the tumors were classified as grade I meningiomas. Additional radiotherapy was beneficial, especially to the patients with grade I tumors [16]. It is evident that meningiomas that invade the orbit pose additional risks to surgical intervention, and each case should be carefully examined.…”

Section: Discussionmentioning

confidence: 99%

Gross and Histological Examination of a Large Spheno-Orbital Meningioma

Kaiser¹,

Reddy²,

Zimmerman³

et al. 2020

Cureus

View full text Add to dashboard Cite

Meningiomas arise from arachnoid cap cells and are the most common heavily researched intracranial tumors. Most of these neoplasms are benign and are classified as World Health Organization (WHO) grade I. They are often found in parasagittal and falx regions, over cerebral convexities, and in the sphenoid ridges. Spheno-orbital meningiomas (SOMs) occupy the cranium and the orbit and are less commonly encountered. Nonetheless, in this case study, a 9.5 cm × 5 cm SOM occurring in a 93-year-old female cadaver was identified and examined. The tumor spanned from the left middle cranial fossa, through the anterior fossa and invaded the orbit. It caused proptosis of the left eye, compression of the temporal lobe, and damage to the optic nerve. Histological examination of the tumor revealed characteristics of a WHO grade I meningothelial meningioma.

show abstract

“…Due to the rare incidence of SOM, the study design was retrospective. Due to the slow growing nature of the intraosseous SOM component, a more extensive follow-up duration of decades would be required for analysis of recurrence rates [11, 44].…”

Section: Discussionmentioning

confidence: 99%

“…Concerning the intraosseous component of SOM, extensions medial to the cranial nerve ostia of the middle cranial fossa render a Simpson °I resection virtually impossible from a standard pterional approach. These growth characteristics contribute to the high recurrence rates of SOM after primary surgery, amounting to up to 60% after 5 years [8–11].…”

Section: Introductionmentioning

confidence: 99%

Challenging the osseous component of sphenoorbital meningiomas

et al. 2019

View full text Add to dashboard Cite

BackgroundIntraosseous growth is a unique feature of sphenoorbital meningiomas (SOM). Its close relation to neurovascular structures limits complete surgical resection and possibly contributes to the high recurrence rate.ObjectiveTo evaluate the growth behavior of intraosseous remnants and develop a protocol for precise intraoperative visualization of intraosseous SOM.MethodsWe included 31 patients operated for SOM from 2004 to 2017. The growth velocity of the intraosseous tumor component was volumetrically calculated in 20 cases. To improve accuracy of image guidance, we implemented a specialized bone surface-based registration algorithm. For intraoperative bone visualization, we included CT in multimodality continuous image guidance in 23 patients. The extent of resection (EOR) was compared with a standard MR-only navigation group (n = 8).ResultsIn 11/20 cases (55%), a progressive regrowth of the intraosseous SOM remnant was noted during a mean follow-up of 52 months (range 20–132 months). We observed a mean increase of 6.2 cm3 (range 0.2–23.7 cm3) per patient and side during the follow-up period. Bone surface-based registration was significantly more accurate than skin surface-based registration (mean 0.7 ± 0.4 mm and 1.9 ± 0.7 mm, p < 0.001). The EOR of the intraosseous component was significantly higher using CT + MRI navigation compared with controls (96% vs. 81%, p = 0.044).ConclusionQuantitative assessment of the biological behavior of intraosseous remnants revealed a continuous slow growth rate independent of the soft tumor component of more than half of SOM. According to our data, application of a multimodal image guidance provided high accuracy and significantly increased the resection rate of the intraosseous component of SOM.

show abstract

Internal and external spheno-orbital meningioma varieties: different outcomes and prognoses

Cited by 32 publications

References 25 publications

Surgery as a safe and effective treatment option for spheno‐orbital meningioma: a systematic review and meta‐analysis of surgical techniques and outcomes

Surgery as a safe and effective treatment option for spheno‐orbital meningioma: a systematic review and meta‐analysis of surgical techniques and outcomes

Gross and Histological Examination of a Large Spheno-Orbital Meningioma

Challenging the osseous component of sphenoorbital meningiomas

Contact Info

Product

Resources

About