Burdenko Neurosurgical Center, Moscow, Russia.
Zh Vopr Neirokhir Im N N Burdenko. 2023;87(1):96-103. doi: 10.17116/neiro20238701196.
Sphenoorbital meningiomas (SOM) are a subgroup of skull base tumors with soft tissue component in the orbit and anterior and/or middle cranial fossa. According to different authors, SOMs account for 2-12% of all intracranial meningiomas. Reconstruction of bone defects after resection of SOM has own nuances. Along with cranial vault repair, patients encounter with cosmetic defects following facial skull lesion, ophthalmic symptoms due to orbital defects, dental and functional problems associated with opening of the mouth in case of damage to maxilla and mandible. Predominant infiltrative growth of tumor and common large bone defects involving various anatomical regions require multiple implants or implants with complex shape. Moreover, contact of implantation area with nasal cavity and paranasal sinuses requires additional impermeability of soft tissue reconstruction and inertness of materials.
To summarize available modern data on bone defect closure after resection of SOM.
The authors reviewed available data on bone defect closure after resection of SOM. Effectiveness of modern methods of reconstruction and safety of materials were assessed.
We analyzed 96 available references. Technical features of tumor resection, materials used for bone defect closure and modern possibilities of 3D technologies in reconstructive surgery were described. The authors proposed the algorithms for selecting the materials for bone defect closure after resection of SOM.
Improvement of surgical technique and development of new materials and technologies significantly improve cosmetic and functional results. A large percentage of negative ophthalmologic outcomes and high risk of complications in SOM surgery require further studies and elaboration of modern techniques.
蝶骨眶脑膜瘤（SOM）是颅底肿瘤的一个亚组，其在眼眶和前颅窝和/或中颅窝具有软组织成分。根据不同的作者，SOM 占所有颅内脑膜瘤的 2-12%。SOM 切除后骨缺损的重建有其自身的特点。除了颅盖修复外，患者还会遇到面部颅骨损伤后的美容缺陷、由于眼眶缺损导致的眼部症状、由于上颌骨和下颌骨损伤导致张口时的牙齿和功能问题。肿瘤的优势浸润性生长和常见的涉及多个解剖区域的大骨缺损需要多个植入物或具有复杂形状的植入物。此外，植入区域与鼻腔和副鼻窦的接触需要软组织重建的额外不透水性和材料的惰性。
总结 SOM 切除后骨缺损闭合的现有现代数据。
作者回顾了 SOM 切除后骨缺损闭合的现有数据。评估了现代重建方法的有效性和材料的安全性。
我们分析了 96 篇现有参考文献。描述了肿瘤切除术的技术特点、用于骨缺损闭合的材料以及重建手术中现代 3D 技术的可能性。作者提出了 SOM 切除后骨缺损闭合的材料选择算法。
手术技术的改进和新材料和技术的发展显著改善了美容和功能结果。SOM 手术中眼科不良结果的高比例和并发症的高风险需要进一步的研究和现代技术的制定。
