Related Experiment Video
Updated: Oct 7, 2025
09:53
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
3.8K
Orbito-cranial schwannoma-a multicentre experience
Yinon Shapira1,2, Valerie Juniat3,4, Tarjani Dave5
1Discipline of Ophthalmology and Visual Science, University of Adelaide, Adelaide, SA, Australia. yinonshapira@gmail.com.
Eye (London, England)
|January 9, 2022
Summary
Orbito-cranial schwannomas can be successfully managed with combined surgical approaches. Complete or subtotal resection, often with an intracapsular technique, can lead to no recurrence, while stereotactic radiotherapy (SRT) aids in controlling progression.
Area of Science:
- Neurosurgery
- Ophthalmology
- Oncology
Background:
- Orbito-cranial schwannomas are rare tumors that present significant management challenges due to their complex anatomical location.
- These tumors can cause significant visual and neurological deficits, necessitating specialized treatment strategies.
Purpose of the Study:
- To describe the clinical features, management strategies, and outcomes of patients with orbito-cranial schwannomas.
- To evaluate the efficacy of combined surgical and adjuvant therapies for these challenging tumors.
Main Methods:
- A retrospective review of ten patients with orbito-cranial schwannomas treated across six orbital services over 22 years.
- Data collected included patient demographics, clinical presentation, neuroimaging findings, histology, surgical techniques, and outcomes, including recurrence and complications.
- Management involved surgical resection, often in collaboration between orbital and neurosurgical teams, with consideration for intracapsular approaches and adjuvant stereotactic radiotherapy (SRT).
Main Results:
- The majority of patients presented with proptosis, limited extraocular motility, and optic neuropathy.
- Most tumors involved the orbital apex, superior orbital fissure, and extended to the cavernous sinus.
- Complete or subtotal resection was achieved in 70% of cases using a combined orbital-neurosurgical intracapsular approach, with no recurrence observed during follow-up (6-186 months). Three patients underwent debulking, with one progressing and requiring SRT.
Conclusions:
- Complex orbito-cranial schwannomas can be successfully managed with a multidisciplinary surgical approach, including intracapsular resection.
- Subtotal excision may prevent recurrence, and observation can be a reasonable strategy in select cases.
- Adjunctive stereotactic radiotherapy (SRT) is a valuable option for managing tumor progression or residual disease.
