Abstract:ObjectiveTo improve the total removal rate and reduce complications via investigating the therapeutic effect and surgical skill for microsurgical resection of sphenoorbital meningioma via orbitozygomatic approach (OZA).MethodsClinical data of 21 patients suffering from sphenoorbital meningioma surgically treated in our department from Jan. 2013 to Sep. 2016 were analyzed retrospectively. The analyzed data included patients' age, gender, clinical symptoms, imaging features, surgical approaches, complications, and recurrence rates.ResultsThe major symptoms of sphenoorbital meningioma were exophthalmos and local pain, although slight decreased vision in some cases. The diameter of the tumors ranged from 3 cm to 7 cm with an average of 4.5. The tumor was totally removed in 14 cases (66.7%), subtotally in 6(28.6%), and partially in one (4.8%). As for the surgical approach, OZA was adopted in 18 cases, and pterional approach combined with limited orbitotomy (only burring the bones around the tumor) in 3 cases including one with recurrence 52 months after the first operation via the modified pterional approach. All the patients were followed up for 3 to 87 months postoperatively. 3 patients had incomplete oculomotor nerve paralysis recovered 3 months later. One had hemiplegia with the muscle strength of the limbs recovered to grade IV+ latterly.ConclusionMeningioma located in the sphenoorbital region can be well exposed via properly modified OZA. Epidural preliminary treatment of the tumor base can significantly reduce bleeding during tumor resection. With proper microsurgical techniques, sphenoorbital meningioma can be satisfactorily removed via this appraoch.
