Sulaiman Injam Ibrahim, Hassan Baker Ali, Shafeeq Azhin, Ismail Mustafa
Department of Surgery, Hawler Medical University, College of Medicine, Erbil, IRQ.
Department of Neurosurgery, Hawler Teaching Hospital, Erbil, IRQ.
Cureus. 2024 Nov 18;16(11):e73908. doi: 10.7759/cureus.73908. eCollection 2024 Nov.
Spheno-orbital meningiomas (SOMs) are rare tumors that involve the sphenoid wing and orbit, leading to symptoms such as proptosis and vision loss. Their proximity to critical neurovascular structures complicates surgical resection, making management challenging. A systematic review of 22 paper series involving 1042 patients was conducted using PubMed and Scopus. Studies focused on SOM diagnosis, surgical techniques, recurrence rates, and the role of adjuvant therapies were analyzed. Proptosis and visual impairment were the most common symptoms. Gross total resection (GTR) reduced recurrence, but subtotal resection (STR) often led to higher recurrence, particularly in optic canal involvement. Minimally invasive approaches showed the potential to reduce morbidity. Adjuvant radiotherapy was effective in controlling tumor growth post-STR. SOM management requires a balance between tumor control and functional preservation. While GTR minimizes recurrence, STR with adjuvant radiotherapy is a viable alternative in challenging cases. Minimally invasive techniques offer promise, but further long-term studies are needed.
蝶骨-眶脑膜瘤（SOMs）是一种罕见的肿瘤，累及蝶骨翼和眼眶，可导致眼球突出和视力丧失等症状。它们靠近关键的神经血管结构，使手术切除变得复杂，给治疗带来挑战。利用PubMed和Scopus对涉及1042例患者的22篇论文系列进行了系统评价。分析了聚焦于SOM诊断、手术技术、复发率及辅助治疗作用的研究。眼球突出和视力损害是最常见的症状。全切除（GTR）可降低复发率，但次全切除（STR）往往导致更高的复发率，尤其是在视神经管受累的情况下。微创方法显示出降低发病率的潜力。辅助放疗在STR后控制肿瘤生长方面有效。SOM的治疗需要在肿瘤控制和功能保留之间取得平衡。虽然GTR可将复发率降至最低，但在具有挑战性的病例中，STR联合辅助放疗是一种可行的替代方案。微创技术前景广阔，但还需要进一步的长期研究。
