Surgical outcomes of spheno-orbital en plaque meningioma: A 10-year experience in 57 consecutive cases.

Abstract: Introduction Spheno-orbital en plaque meningioma is located in a sensitive and complex cranial region. Therefore, the therapeutic approach for this type of tumor is of great importance. We aimed to examine the clinical and radiological outcomes of patients diagnosed with sphenoid wing en plaque meningioma undergoing surgery. Methods In this case series, the results of clinical and functional assessments, as well as appearance before and after surgery, were examined in 57 patients with spheno-orbital en plaque meningioma, undergoing surgery with the frontotemporal approach during 2007-2017. Data were entered in the designed forms and statistically analyzed. Results Proptosis, headache, and vision impairment were detected in 47 (83%), 33 (58%), and 16 (28%) patients, respectively. Eight (14%) patients complained of diplopia, while 3 (8%) patients complained of ptosis. In all patients, proptosis improved following surgery. Complete treatment of proptosis was reported in 42 cases, and significant improvement was observed in five cases. Sixteen patients experienced visual impairment before surgery, seven of whom showed improvements after surgery, while one showed deteriorated visual acuity after surgery. Total tumor resection was achieved in 48 (84%) patients. Tumor relapse was reported in 7 (12.5%) patients during follow-up. One patient had undergone repeated surgery, one patient was treated with radiotherapy alone, and five patients underwent combined treatment. Conclusion Total tumor resection can be achieved with minimal complications by using microscopic dissection and sufficient bone and orbital wall resection. An important point in the treatment of these patients is the appropriate restoration of the orbital wall.