Spheno-Orbital Meningioma with Cavernous Sinus Extension

Area of Science:

• Neurosurgery
• Ophthalmology
• Oncology

Background:

• Spheno-orbital meningiomas are rare tumors that can cause significant proptosis and cranial nerve deficits.
• En plaque meningiomas involving the sphenoid bone and orbit present unique surgical challenges.
• Cavernous sinus involvement necessitates careful surgical planning to avoid neurological injury.

Purpose of the Study:

• To present a case of extensive en plaque spheno-orbital meningioma with cavernous sinus invasion.
• To illustrate the surgical technique for complete tumor removal via a cranio-orbital zygomatic approach.
• To demonstrate the feasibility of preserving cranial nerve function during aggressive tumor resection.

Main Methods:

• A 37-year-old female patient with left eye proptosis underwent a cranio-orbital zygomatic approach.
• Surgical steps included extradural clinoidectomy, extensive orbital bone removal, and cavernous sinus wall exposition.
• Total tumor removal was achieved with meticulous peeling of the cavernous sinus lateral wall, preserving cranial nerves.

Main Results:

• Complete resection of the extensive spheno-orbital meningioma was achieved.
• All involved cranial nerves within the cavernous sinus were preserved anatomically and functionally.
• The patient's proptosis was addressed with successful tumor removal.

Conclusions:

• Aggressive, first-time surgical removal is crucial for extensive spheno-orbital meningiomas.
• Cavernous sinus invasion by meningiomas can be safely resected with preservation of cranial nerve function.
• The cranio-orbital zygomatic approach provides adequate exposure for complex spheno-orbital meningioma resection.