PDF(Pubmed)
Abstract：
Surgery stands as the primary treatment for spheno-orbital meningiomas, following a symptoms-oriented approach. We discussed the decision-making process behind surgical strategies through a review of medical records from 80 patients who underwent surgical resection at the University of Naples Federico II. Different surgical approaches were employed based on the tumor\'s location relative to the optic nerve\'s long axis, categorized into lateral (type I), medial (type II), and diffuse (type III). We examined clinical, neuroradiological, surgical, pathological, and outcome factors. Proptosis emerged as the most frequent symptom (97%), followed by visual impairment (59%) and ocular motility issues (35%). Type I represented 20%, type II 43%, and type III 17%. Growth primarily affected the optic canal (74%), superior orbital fissure (65%), anterior clinoid (60%), and orbital apex (59%). The resection outcomes varied, with Simpson grades I and II achieved in all type I cases, 67.5% of type II, and 18% of type III. Recurrence rates were highest in type II (41.8%) and type III (59%). Improvement was notable in proptosis (68%) and visual function (51%, predominantly type I). Surgery for spheno-orbital meningiomas should be tailored to each patient, considering individual characteristics and tumor features to improve quality of life by addressing primary symptoms like proptosis and visual deficits.
摘要：
手术是蝶眶脑膜瘤的主要治疗方法，遵循面向症状的方法。我们通过回顾那不勒斯费德里科大学接受手术切除的80例患者的病历，讨论了手术策略背后的决策过程。根据肿瘤相对于视神经长轴的位置，采用不同的手术方法。分类为横向(I型)，内侧（II型），和弥漫性（III型）。我们检查了临床，神经放射学，外科,病态,和结果因素。出现了最常见的症状（97％），其次是视力障碍（59％）和眼运动问题（35％）。I型占20%，II型43%,和III型17%。生长主要影响视神经管（74％），上眶裂隙（65%），前斜骨（60％），和眶尖（59％）。切除结果各不相同，辛普森在所有I型病例中都达到了I级和II级，II型的67.5%，和18%的III型。Ⅱ型(41.8%)和Ⅲ型(59%)复发率最高。眼球突出(68%)和视觉功能(51%，主要是I型)。蝶眶脑膜瘤的手术应针对每位患者，考虑个体特征和肿瘤特征，通过解决原发性症状如眼球突出和视力缺陷来改善生活质量。
