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Recurrent spheno-orbital meningioma
J C Maroon1, J S Kennerdell, D V Vidovich
1Department of Neurosurgery, Medical College of Pennsylvania, Pittsburgh.
Journal of Neurosurgery
|February 1, 1994
Summary
Aggressive surgical resection of recurrent spheno-orbital meningioma in 15 patients led to no deaths and significant cosmetic improvement. Early, thorough removal is crucial to prevent recurrence and improve outcomes.
Area of Science:
- Neurosurgery
- Oncology
- Ophthalmology
Background:
- Recurrent spheno-orbital meningiomas present significant surgical challenges.
- Tumor recurrence often necessitates reoperation, with potential for increased morbidity.
Purpose of the Study:
- To report the outcomes of aggressive surgical resection for recurrent spheno-orbital meningioma.
- To discuss surgical techniques, adjuvant therapy, and prognostic factors.
Main Methods:
- Retrospective case series of 15 patients undergoing reoperation for spheno-orbital meningioma.
- Detailed analysis of surgical technique, including extent of resection and management of dural involvement.
- Evaluation of postoperative outcomes, including morbidity, cosmetic results, and recurrence rates.
Main Results:
- Aggressive resection resulted in no mortality and minimal morbidity, with one case of blindness due to central retinal artery occlusion.
- Fourteen patients experienced cosmetic improvement; one had persistent proptosis due to inadequate initial bone removal.
- Nine patients had complete gross tumor excision; 10 received radiation therapy for residual tumor in critical areas.
Conclusions:
- Early, aggressive surgical resection of spheno-orbital meningioma is vital for optimal outcomes.
- Advanced imaging like gadolinium-enhanced MRI is crucial for detecting intracranial dural involvement.
- Radiation therapy plays a role in managing incomplete resections or when cavernous sinus involvement is a concern.