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Orbital decompressive effect of endoscopic transorbital surgery for sphenoorbital meningioma

  • Oculoplastics and Orbit
  • Published:
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Abstract

Purpose

This study was aimed at evaluating the orbital decompressive effect of endoscopic transorbital approach (TOA) in the management of sphenoorbital meningioma involving the orbit.

Methods

Patients treated with TOA for this tumor from December 2016 to December 2019 were included, and the data were reviewed. Pre- and postoperative clinical and imaging findings were compared with a volumetric study.

Results

Eighteen patients (two men and 16 women) were included. Lateral wall hyperostosis (13 patients), extraconal tumor infiltration (18 patients), intraconal tumor infiltration (seven patients), and superior and lateral rectus encasement (nine patients) were found. Intraconal tumor infiltration in the posterior orbit affected compressive optic neuropathy (CON) more often than other tumor manifestations. The orbital soft tissue volume decreased to 91.18% ± 8.19% compared to that in the contralateral side preoperatively. The postoperative volume increased to 113.73% ± 12.92% compared to the preoperative volume. The average values of LogMAR visual acuity and visual field index score of ten patients with CON improved from 0.80 to 0.42 and 48.9 to 65.9%, respectively. All 17 patients with proptosis showed improvement after surgery. There were no significant complications associated with the surgery. Additional treatment, including gamma knife surgery, was applied to 12 cases for the remaining tumor.

Conclusion

This minimally invasive surgical debulking procedure was successful in treating sphenoorbital meningioma without significant adverse events. Lateral orbital wall decompression and limited intraorbital tumor resection were effective for compressive orbitopathy from the tumor.

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References

  1. Marosi C, Hassler M, Roessler K, Reni M, Sant M, Mazza E, Vecht C (2008) Meningioma. Crit Rev Oncol Hematol 67:153–171

    Article  Google Scholar 

  2. Amirjamshidi A, Abbasioun K, Amiri RS, Ardalan A, Hashemi SM (2015) Lateral orbitotomy approach for removing hyperostosing en plaque sphenoid wing meningiomas. Description of surgical strategy and analysis of findings in a series of 88 patients with long-term follow up. Surg Neurol Int 6:79

    Article  Google Scholar 

  3. Boari N, Gagliardi F, Spina A, Bailo M, Franzin A, Mortini P (2013) Management of spheno-orbital en plaque meningiomas: clinical outcome in a consecutive series of 40 patients. Br J Neurosurg 27:84–90

    Article  Google Scholar 

  4. Jian T, Sun F, Tang D, Wang S, Wu T, Zhao L (2015) Clinical analysis of transcranial orbitotomy approach on cranio-orbital tumors. J Craniofac Surg 26:441–446

    Article  Google Scholar 

  5. Mariniello G, Maiuri F, Strianese D, Donzelli R, Iuliano A, Tranfa F, de Divitiis E, Bonavolonta G (2008) Spheno-orbital meningiomas: surgical approaches and outcome according to the intraorbital tumor extent. Zentralbl Neurochir 69:175–181

    Article  CAS  Google Scholar 

  6. McDermott MW, Durity FA, Rootman J, Woodhurst WB (1990) Combined frontotemporal-orbitozygomatic approach for tumors of the sphenoid wing and orbit. Neurosurgery 26:107–116

    Article  CAS  Google Scholar 

  7. Ringel F, Cedzich C, Schramm J (2007) Microsurgical technique and results of a series of 63 spheno-orbital meningiomas. Neurosurgery 60:214–221 discussion 221-212

    PubMed  Google Scholar 

  8. Cannon PS, Rutherford SA, Richardson PL, King A, Leatherbarrow B (2009) The surgical management and outcomes for spheno-orbital meningiomas: a 7-year review of multi-disciplinary practice. Orbit 28:371–376

    Article  Google Scholar 

  9. Freeman JL, Davern MS, Oushy S, Sillau S, Ormond DR, Youssef AS, Lillehei KO (2017) Spheno-orbital meningiomas: a 16-year surgical experience. World Neurosurg 99:369–380

    Article  Google Scholar 

  10. Terrier LM, Bernard F, Fournier HD, Morandi X, Velut S, Henaux PL, Amelot A, Francois P (2018) Spheno-orbital meningiomas surgery: multicenter management study for complex extensive tumors. World Neurosurg 112:e145–e156

    Article  Google Scholar 

  11. Shrivastava RK, Sen C, Costantino PD, Della Rocca R (2005) Sphenoorbital meningiomas: surgical limitations and lessons learned in their long-term management. J Neurosurg 103:491–497

    Article  Google Scholar 

  12. Peron S, Cividini A, Santi L, Galante N, Castelnuovo P, Locatelli D (2017) Spheno-orbital meningiomas: when the endoscopic approach is better. Acta Neurochir Suppl 124:123–128

    Article  Google Scholar 

  13. Locatelli D, Pozzi F, Turri-Zanoni M, Battaglia P, Santi L, Dallan I, Castelnuovo P (2016) Transorbital endoscopic approaches to the skull base: current concepts and future perspectives. J Neurosurg Sci 60:514–525

    PubMed  Google Scholar 

  14. Dallan I, Castelnuovo P, Locatelli D, Turri-Zanoni M, AlQahtani A, Battaglia P, Hirt B, Sellari-Franceschini S (2015) Multiportal combined transorbital transnasal endoscopic approach for the management of selected skull base lesions: preliminary experience. World Neurosurg 84:97–107

    Article  Google Scholar 

  15. Dallan I, Sellari-Franceschini S, Turri-Zanoni M, de Notaris M, Fiacchini G, Fiorini FR, Battaglia P, Locatelli D, Castelnuovo P (2018) Endoscopic transorbital superior eyelid approach for the management of selected spheno-orbital meningiomas: preliminary experience. Oper Neurosurg (Hagerstown) 14:243–251

    Article  Google Scholar 

  16. Almeida JP, Omay SB, Shetty SR, Chen YN, Ruiz-Trevino AS, Liang B, Anand VK, Levine B, Schwartz TH (2018) Transorbital endoscopic eyelid approach for resection of sphenoorbital meningiomas with predominant hyperostosis: report of 2 cases. J Neurosurg 128:1885–1895

    Article  Google Scholar 

  17. Luzzi S, Zoia C, Rampini AD, Elia A, Del Maestro M, Carnevale S, Morbini P, Galzio R (2019) Lateral transorbital neuroendoscopic approach for intraconal meningioma of the orbital apex: technical nuances and literature review. World Neurosurg 131:10–17

    Article  Google Scholar 

  18. Kong DS, Kim YH, Hong CK (2020) Optimal indications and limitations of endoscopic transorbital superior eyelid surgery for spheno-orbital meningiomas. J Neurosurg:1–8

  19. Kong DS, Young SM, Hong CK, Kim YD, Hong SD, Choi JW, Seol HJ, Lee JI, Shin HJ, Nam DH, Woo KI (2018) Clinical and ophthalmological outcome of endoscopic transorbital surgery for cranioorbital tumors. J Neurosurg:1–9

  20. Nakazawa H, Mori Y, Komori M, Shibamoto Y, Tsugawa T, Kobayashi T, Hashizume C (2014) Validation of accuracy in image co-registration with computed tomography and magnetic resonance imaging in gamma knife radiosurgery. J Radiat Res 55:924–933

    Article  Google Scholar 

  21. Leroy HA, Leroy-Ciocanea CI, Baroncini M, Bourgeois P, Pellerin P, Labreuche J, Duhamel A, Lejeune JP (2016) Internal and external spheno-orbital meningioma varieties: different outcomes and prognoses. Acta Neurochir 158:1587–1596

    Article  Google Scholar 

  22. Goldberg RA, Kim AJ, Kerivan KM (1998) The lacrimal keyhole, orbital door jamb, and basin of the inferior orbital fissure. Three areas of deep bone in the lateral orbit. Arch Ophthalmol 116:1618–1624

    Article  CAS  Google Scholar 

  23. Baldeschi L, MacAndie K, Hintschich C, Wakelkamp IM, Prummel MF, Wiersinga WM (2005) The removal of the deep lateral wall in orbital decompression: its contribution to exophthalmos reduction and influence on consecutive diplopia. Am J Ophthalmol 140:642–647

    Article  Google Scholar 

  24. 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 153:395–402

    Article  Google Scholar 

  25. Kim KH, Kang SJ, Choi JW, Kong DS, Seol HJ, Nam DH, Lee JI (2018) Clinical and radiological outcomes of proactive gamma knife surgery for asymptomatic meningiomas compared with the natural course without intervention. J Neurosurg:1–10

  26. Lam Shin Cheung V, Kim A, Sahgal A, Das S (2018) Meningioma recurrence rates following treatment: a systematic analysis. J Neuro-Oncol 136:351–361

    Article  Google Scholar 

  27. Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW (2016) The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 131:803–820

    Article  Google Scholar 

  28. Belinsky I, Murchison AP, Evans JJ, Andrews DW, Farrell CJ, Casey JP, Curtis MT, Nowak Choi KA, Werner-Wasik M, Bilyk JR (2018) Spheno-orbital meningiomas: an analysis based on World Health Organization classification and Ki-67 proliferative index. Ophthalmic Plast Reconstr Surg 34:143–150

    Article  Google Scholar 

  29. Honig S, Trantakis C, Frerich B, Sterker I, Kortmann RD, Meixensberger J (2010) Meningiomas involving the sphenoid wing outcome after microsurgical treatment--a clinical review of 73 cases. Cent Eur Neurosurg 71:189–198

    Article  CAS  Google Scholar 

  30. Talacchi A, De Carlo A, D'Agostino A, Nocini P (2014) Surgical management of ocular symptoms in spheno-orbital meningiomas. Is orbital reconstruction really necessary? Neurosurg Rev 37:301–309 discussion 309-310

    Article  Google Scholar 

  31. Yannick N, Patrick F, Samuel M, Erwan F, Pierre-Jean P, Michel J, Stephane V (2012) Predictive factors for visual outcome after resection of spheno-orbital meningiomas: a long-term review. Acta Ophthalmol 90:e663–e665

    Article  Google Scholar 

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Author information

Author notes

  1. Kyung In Woo and Doo-sik Kong equally contributed to this manuscript as first authors.

Authors and Affiliations

  1. Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro Kangnam-ku, Seoul, 06351, South Korea

    Kyung In Woo, Ji Woong Park & Yoon-Duck Kim

  2. Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Doo-sik Kong & Minsoo Kim

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  1. Kyung In Woo
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Correspondence to Kyung In Woo.

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The authors confirm that the study was approved by the Institutional Review Board of the Samsung Seoul Hospital and certify that the study was performed in accordance with the ethical standards of the Declaration of Helsinki.

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In Woo, K., Kong, Ds., Park, J.W. et al. Orbital decompressive effect of endoscopic transorbital surgery for sphenoorbital meningioma. Graefes Arch Clin Exp Ophthalmol 259, 1015–1024 (2021). https://doi.org/10.1007/s00417-020-05008-9

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  • DOI: https://doi.org/10.1007/s00417-020-05008-9

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