[Surgical treatment of optic foraminal meningiomas, surgical technique and outcomes from a series of 18 patients].

INTRODUCTION

Optic foraminal meningiomas produce a rapid deterioration of visual function even when its size is small, thus diagnosis and management differ from other clinoideal meningiomas. The purpose of this study is to present the technique for excision and results of our series of foraminal meningiomas (FM).

PATIENTS AND METHODS

A review of medical records of 47 patients harboring primary intraorbital meningiomas (PIM) was performed. In PIM patients fifty two operations were carried out. Fronto-orbital craniotomy was employed followed by extradural decompression of the optic canal, resection of the intraorbital component, and exploration of the optic nerve intradurally.

RESULTS

Among 12 patients with PIM who had useful vision preoperatively the visual acuity was preserved in 7 cases, improved in 2, and worsened in 3 cases. In 18 patients exophthalmos was the main symptom and in 35 patients unilateral blindness. Six recurrences occurred 2 to 10 years after surgery. Five of them were reoperated on. We indicated radiotherapy after recurrence in 3 patients.

CONCLUSION

The management of PIM remains controversial and conservative management is frequently proposed. Based on our frequent findings of intracranial extension, our approach has been to perform a total or subtotal removal of the tumor, sparing the optic nerve in patients with useful preoperative vision.