J Korean Neurosurg Soc.  2022 May;65(3):449-456. 10.3340/jkns.2021.0109.

Surgical Outcomes of Sphenoid Wing Meningioma with Periorbital Invasion

• Park GO
• Park HH
• Yoo J
• Hong CK
• Oh J

• KMID: 2529590
• DOI: http://doi.org/10.3340/jkns.2021.0109

Abstract

Objective
: The aim of this study was to evaluate the clinical outcome of sphenoid wing meningioma with periorbital invasion (PI) after operation.
Methods
: Sixty one patients with sphenoid wing meningioma were enrolled in this study. Their clinical conditions were monitored after the operation and followed up more than 5 years at the outpatient clinic of a single institution. Clinical and radiologic information of the patients were all recorded including the following parameters : presence of PI, presence of peri-tumor structure invasion, pathologic grade, extents of resection, presence of hyperostosis, exophthalmos index (EI), and surgical complications. We compared the above clinical parameters of the patients with sphenoid wing meningioma in the presence or absence of PI (non-PI), then linked the analyzed data with the clinical outcome of the patients.
Results
: Of 61 cases, there were 14 PI and 47 non-PI patients. PI group showed a significantly higher score of EI (1.37±0.24 vs. 1.00±0.01, p<0.001), more frequent presence of hyperostosis (85.7% vs. 14.3%, p<0.001), and lower rate of gross total resection (GTR) (35.7% vs. 68.1%, p=0.032). The lower score of pre-operative EI, the absence of both PI and hyperostosis, smaller tumor size, and the performance of GTR were associated with lower recurrence rates in the univariate analysis. However, in the multivariate analysis, the performance of GTR was the only significant factor to determine the recurrence rate (p=0.043). The incidences of surgical complications were not statistically different between the subtotal resection (STR) and GTR groups, but it was strongly associated tumor size (p=0.017).
Conclusion
: The GTR group showed lower recurrence rate than the STR group without differences in the surgical complications. Therefore, the GTR is strongly recommended to treat sphenoid wing meningioma with PI for the better clinical outcome.

Keyword

Meningioma; Sphenoid bone; Orbit; Hyperostosis; Neurosurgical procedures; Treatment outcome

Figure

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  Fig. 1. Definition of exophthalmos index (EI). EI=a/b. The length of perpendicular line from the base line connecting the bilateral zygomatic bones to the most anterior point of the orbital globe is measured for both eyes. The ratio of the length (a) of the ipsilateral side of the tumor over the length (b) of the contralateral side of the tumor were calculated as EI score.

Reference

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