Current surgical treatment for sphenoorbital meningiomas.

BACKGROUND

Originally, the authors used a combined transcranial-transmalar approach for removal of sphenoorbital tumors.

METHODS

More recently, when computed tomography (CT) scanning became available, surgical management of sphenoorbital meningiomas included resection of the hyperostosis in the pterional region, orbital roof and lateral wall, and middle fossa floor. Thereafter, intradural and intraorbital components are removed, as well as infiltrated dura mater. Finally, a periosteal flap is placed over the dural defect and bone reconstructed with methylmethacrylate.

RESULTS

Of 25 patients, there was only one death and all but one showed very good to moderate response to treatment. Four recurrences were observed.

CONCLUSIONS

Surgical management cannot be uniform in all cases, but must be adapted to each form of presentation. On the basis of the satisfactory results achieved, we feel justified in advising the technique described above with its current modifications.