Acta Neurochirurgica

, Volume 153, Issue 7, pp 1541–1541 | Cite as

Surgical management of spheno-orbital meningiomas

  • Kimihiro NagataniEmail author
  • Satoru Takeuchi
  • Naoki Otani
  • Hiroshi Nawashiro


Meningioma Cranial Nerve Nerve Palsy Cavernous Sinus Surgical Morbidity 
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We read with great interest the article entitled “Natural history of spheno-orbital meningiomas” by Saeed et al. [3]. The authors investigated the natural history and growth rate of spheno-orbital meningiomas (SOMs). They reported that a significant number of SOMs were slow-growing tumors and that the initial volume of the tumor and of the soft tissue component was significantly related to the growth rate. Therefore, they advocated a “wait and see” policy in the absence of risk factors. We wish to provide further comment on the issue of surgical morbidity and mortality, which was anticipated by the authors, in the case of SOMs. Oya et al. [2] reviewed 39 patients who had SOMs and had undergone surgery; they reported that persistent oculomotor palsy occurred in three cases (7.7%). They avoided radical resection of portions of the tumor that extended into the cavernous sinus (CS) and superior orbital fissure (SOF) in order to minimize the risk of permanent oculomotor nerve palsy. Mirone et al. [1] also studied a series of 71 patients who had undergone surgery for SOMs. They reported that persistent oculomotor palsy occurred in three cases (4.2%) and that there were no perioperative deaths related to surgery. In their series, the CS and SOF constituted the surgical limits in order to avoid the risk of permanent cranial nerve deficit. On the basis of these reports, we consider that low morbidity and mortality rates can be achieved with surgery limited by the CS and SOF. Unfortunately, the biological behavior of SOMs varies, and some SOMs grow much faster than others [1, 3, 4]. Therefore, we feel that good tumor control of SOMs without morbidity is essential and that resection should be limited up to the CS and SOF to achieve adequate tumor resection with low morbidity.


Conflicts of interest



  1. 1.
    Mirone G, Chibbaro S, Schiabello L, Tola S, George B (2009) En plaque sphenoid wing meningiomas: recurrence factors and surgical strategy in a series of 71 patients. Neurosurgery 65:100–108PubMedCrossRefGoogle Scholar
  2. 2.
    Oya S, Sade B, Lee JH (2010) Sphenoorbital meningioma:surgical technique and outcome. J Neurosurg. doi: 10.3171/2011.1.JNS101128a Google Scholar
  3. 3.
    Saeed P, van Furth WR, Tanck M, Kooremans F, Freling N, Streekstra GI, Regensburg NI, van der Sprenkel JW, Peerdeman SM, van Overbeeke JJ, Mourits MP (2011) Natural history of spheno-orbital meningiomas. Acta Neurochir (Wien) 153:395–402CrossRefGoogle Scholar
  4. 4.
    Schick U, Bleyen J, Bani A, Hassler W (2006) Management of meningiomas en plaque of the sphenoid wing. J Neurosurg 104:208–214PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Kimihiro Nagatani
    • 1
    Email author
  • Satoru Takeuchi
    • 1
  • Naoki Otani
    • 1
  • Hiroshi Nawashiro
    • 1
  1. 1.Department of NeurosurgeryNational Defense Medical CollegeTokorozawaJapan

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