He Haiyong, Li Manting, Luo Lun, Guo Ying, Li Wensheng
Department of Neurosurgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China.
J Craniofac Surg. 2023;34(5):1439-1443. doi: 10.1097/SCS.0000000000009358. Epub 2023 May 23.
Reactive hyperostosis of spheno-orbital meningiomas (SOMs) often occurred in the sphenoid wing, while osteolytic SOMs (O-SOMs) were rarely discussed. This study preliminarily evaluated the clinical characteristics of O-SOMs and analyzed prognostic factors affecting the recurrence of SOMs. We retrospectively analyzed the medical records of consecutive patients who underwent surgery for a SOM between 2015 and 2020. According to the bone changes of sphenoid wing, SOMs were divided into O-SOMs and hyperostosis SOMs (H-SOMs). A total of 31 procedures were performed in 28 patients. All cases were treated by pterional-orbital approach. It was confirmed that 8 cases were O-SOMs and the other 20 cases were H-SOMs. Total tumor resection was performed in 21 cases. There were 19 cases with Ki 67 ≥3%. The patients were followed up for 3 to 87 months. Proptosis improved in all patients. All O-SOMs had no visual deterioration, while 4 H-SOMs cases had visual deterioration. There was no significant difference in clinical outcomes between the two types of SOM. The recurrence of SOM was related to the degree of resection, but not to the type of bone lesions, invasion of cavernous sinus and Ki 67.
蝶骨嵴脑膜瘤(SOMs)的反应性骨质增生常发生于蝶骨嵴,而溶骨性SOMs(O-SOMs)则鲜有讨论。本研究初步评估了O-SOMs的临床特征,并分析了影响SOMs复发的预后因素。我们回顾性分析了2015年至2020年间连续接受SOM手术患者的病历。根据蝶骨嵴的骨质改变,SOMs分为O-SOMs和骨质增生型SOMs(H-SOMs)。28例患者共进行了31次手术。所有病例均采用翼点眶上锁孔入路治疗。确诊为O-SOMs 8例,H-SOMs 20例。21例行肿瘤全切除。19例Ki 67≥3%。患者随访3至87个月。所有患者突眼均有改善。所有O-SOMs患者视力均无恶化,而4例H-SOMs患者出现视力恶化。两种类型的SOM临床结局无显著差异。SOMs的复发与切除程度有关,而与骨病变类型、海绵窦侵犯及Ki 67无关。