[Surgery for hyperostotic cranial orbital meningiomas]

The paper analyzes surgical techniques for removal of hyperostotic cranial orbital meningiomas in 36 patients operated on in 1998 to 2000. In 19 cases hyperostosis extends to the upper and lower lid slits without involving the optic canal. It also spreads to the ethmoidal sinus in 6 cases to the frontal sinus in 3, and to the maxillary one in 2 patients. In 3 patients, hyperostosis was beyond the wing of the basic bone, by involving the temporal and frontal squamous. In 19 cases, hyperostosis was resected and the tumor was removed without creating any additional bone flaps. To make an additional basal bone flap can provide a much wider access by reducing the traction of both orbital and cerebral tissues. An orbitozygomatic flap was formed in 16 cases. To create a lateral orbital flap was sufficient to effectively eliminate hyperostosis in 3 patients. Impaired postoperative visual acuity was observed in 5 patients undergone resection for the hyperostotic optic canal, in 2 patients of them there was a decrease in visual acuity from 1.0 to 0.1 and in 1 patient it reduced from 1.0 to 0.2. A year later, visual acuity in these patients increased up to 0.5-0.8. After resection of the hyperostotic optic canal, blindness occurred in 2 patients, in one of them, photoperception appeared on day 5 after surgery and 3 months later visual acuity restored up to 0.6. Thus, the use of high-speed drill and the creation of an orbital or orbitozygomatic flap can increase the efficiency of removal of hyperostotic cranial orbital meningiomas.