Abstract
Objective. The clinical results of combined surgical-radiosurgical treatment of the spheno-orbital en plaque meningiomas in a consecutive series of 40 patients are presented. The clinical outcome is evaluated in terms of surgical morbidity, tumour control, visual function and cosmetic result. Methods. Forty patients harbouring spheno-orbital en plaque meningiomas were treated. Forty-two surgical procedures were performed through a fronto-temporal craniotomy. The reconstruction of the orbital walls was performed using a titanium mesh. In case of sub-total resection, the patients underwent Gamma-Knife radiosurgery on residual tumour. Visual function was evaluated considering visual acuity tested with a Snellen chart, funduscopy and Goldmann perimetry for visual field defects. Proptosis was quantified on CT scans. Results. Total or gross-total tumour resection was achieved in 56.1% of cases. Permanent morbidity was recorded in three patients after surgery. Visual acuity and visual field defect both improved in 66.7% of patients; improvement of proptosis was recorded in 92.7% of cases. Eighteen patients were treated with Gamma-Knife radiosurgery for residual tumour after surgery and four patients for tumour relapse at follow-up. The mean follow-up period was 72.6 months. Conclusions. Surgical treatment of spheno-orbital en plaque meningiomas is safe and effective: a low morbidity rate was recorded and visual function improved in about two-thirds of patients. Reconstruction of the orbital walls with titanium mesh provides for good functional and cosmetic results. In case of superior orbital fissure and cavernous sinus invasion, the combined surgical- radiosurgical treatment allows to minimise surgical morbidity and to achieve tumour control.
| Original language | English |
|---|---|
| Pages (from-to) | 84-90 |
| Number of pages | 7 |
| Journal | British Journal of Neurosurgery |
| Volume | 27 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Feb 2013 |
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Keywords
- Bone hyperostosis
- Cranio-orbital approach
- Gamma Knife
- Meningioma
- Skull base tumours
- Visual outcome
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
Cite this
Management of spheno-orbital en plaque meningiomas : Clinical outcome in a consecutive series of 40 patients. / Boari, Nicola; Gagliardi, Filippo; Spina, Alfio; Bailo, Michele; Franzin, Alberto; Mortini, Pietro.
In: British Journal of Neurosurgery, Vol. 27, No. 1, 02.2013, p. 84-90.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Management of spheno-orbital en plaque meningiomas
T2 - Clinical outcome in a consecutive series of 40 patients
AU - Boari, Nicola
AU - Gagliardi, Filippo
AU - Spina, Alfio
AU - Bailo, Michele
AU - Franzin, Alberto
AU - Mortini, Pietro
PY - 2013/2
Y1 - 2013/2
N2 - Objective. The clinical results of combined surgical-radiosurgical treatment of the spheno-orbital en plaque meningiomas in a consecutive series of 40 patients are presented. The clinical outcome is evaluated in terms of surgical morbidity, tumour control, visual function and cosmetic result. Methods. Forty patients harbouring spheno-orbital en plaque meningiomas were treated. Forty-two surgical procedures were performed through a fronto-temporal craniotomy. The reconstruction of the orbital walls was performed using a titanium mesh. In case of sub-total resection, the patients underwent Gamma-Knife radiosurgery on residual tumour. Visual function was evaluated considering visual acuity tested with a Snellen chart, funduscopy and Goldmann perimetry for visual field defects. Proptosis was quantified on CT scans. Results. Total or gross-total tumour resection was achieved in 56.1% of cases. Permanent morbidity was recorded in three patients after surgery. Visual acuity and visual field defect both improved in 66.7% of patients; improvement of proptosis was recorded in 92.7% of cases. Eighteen patients were treated with Gamma-Knife radiosurgery for residual tumour after surgery and four patients for tumour relapse at follow-up. The mean follow-up period was 72.6 months. Conclusions. Surgical treatment of spheno-orbital en plaque meningiomas is safe and effective: a low morbidity rate was recorded and visual function improved in about two-thirds of patients. Reconstruction of the orbital walls with titanium mesh provides for good functional and cosmetic results. In case of superior orbital fissure and cavernous sinus invasion, the combined surgical- radiosurgical treatment allows to minimise surgical morbidity and to achieve tumour control.
AB - Objective. The clinical results of combined surgical-radiosurgical treatment of the spheno-orbital en plaque meningiomas in a consecutive series of 40 patients are presented. The clinical outcome is evaluated in terms of surgical morbidity, tumour control, visual function and cosmetic result. Methods. Forty patients harbouring spheno-orbital en plaque meningiomas were treated. Forty-two surgical procedures were performed through a fronto-temporal craniotomy. The reconstruction of the orbital walls was performed using a titanium mesh. In case of sub-total resection, the patients underwent Gamma-Knife radiosurgery on residual tumour. Visual function was evaluated considering visual acuity tested with a Snellen chart, funduscopy and Goldmann perimetry for visual field defects. Proptosis was quantified on CT scans. Results. Total or gross-total tumour resection was achieved in 56.1% of cases. Permanent morbidity was recorded in three patients after surgery. Visual acuity and visual field defect both improved in 66.7% of patients; improvement of proptosis was recorded in 92.7% of cases. Eighteen patients were treated with Gamma-Knife radiosurgery for residual tumour after surgery and four patients for tumour relapse at follow-up. The mean follow-up period was 72.6 months. Conclusions. Surgical treatment of spheno-orbital en plaque meningiomas is safe and effective: a low morbidity rate was recorded and visual function improved in about two-thirds of patients. Reconstruction of the orbital walls with titanium mesh provides for good functional and cosmetic results. In case of superior orbital fissure and cavernous sinus invasion, the combined surgical- radiosurgical treatment allows to minimise surgical morbidity and to achieve tumour control.
KW - Bone hyperostosis
KW - Cranio-orbital approach
KW - Gamma Knife
KW - Meningioma
KW - Skull base tumours
KW - Visual outcome
UR - http://www.scopus.com/inward/record.url?scp=84872694592&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84872694592&partnerID=8YFLogxK
U2 - 10.3109/02688697.2012.709557
DO - 10.3109/02688697.2012.709557
M3 - Article
C2 - 22905887
AN - SCOPUS:84872694592
VL - 27
SP - 84
EP - 90
JO - British Journal of Neurosurgery
JF - British Journal of Neurosurgery
SN - 0268-8697
IS - 1
ER -