Abstract：
BACKGROUND: Spheno-orbital meningiomas (SOMs) pose a challenge to the skull base neurosurgeon because of their variable presentation and involvement of critical structures within the orbit. There is no consensus on optimal management of these patients and how to achieve maximal safe resection. The authors share an illustrative case with an accompanying video to demonstrate their aggressive approach to resect SOMs and their intraorbital components.
METHODS: A 75-year-old-woman presented with progressive vision loss and proptosis. Magnetic resonance imaging was consistent with a large, left-sided sphenoid wing meningioma with extension to the orbital wall and compression of the optic nerve medially. The patient elected to undergo surgical excision and optic nerve decompression. She did well postoperatively with resolution of proptosis and good resection margins on follow-up imaging.
CONCLUSIONS: Aggressive resection of SOMs is possible with an understanding of the underlying anatomy. Familiarity with the orbit can facilitate a maximal safe resection with optic nerve decompression.
METHODS: A 75-year-old-woman presented with progressive vision loss and proptosis. Magnetic resonance imaging was consistent with a large, left-sided sphenoid wing meningioma with extension to the orbital wall and compression of the optic nerve medially. The patient elected to undergo surgical excision and optic nerve decompression. She did well postoperatively with resolution of proptosis and good resection margins on follow-up imaging.
CONCLUSIONS: Aggressive resection of SOMs is possible with an understanding of the underlying anatomy. Familiarity with the orbit can facilitate a maximal safe resection with optic nerve decompression.
摘要：
背景：蝶眶脑膜瘤（SOM）对颅底神经外科医生构成了挑战，因为它们的表现可变，并且涉及眼眶内的关键结构。对于这些患者的最佳管理以及如何实现最大的安全切除尚无共识。作者与随附的视频分享了一个说明性案例，以演示他们积极的方法来切除SOM及其眶内成分。
方法：一名75岁女性出现进行性视力丧失和眼球突出。磁共振成像与大，左侧蝶骨翼脑膜瘤，延伸到眶壁，内侧视神经受压。患者选择接受手术切除和视神经减压术。她术后表现良好，眼球突出消退，随访影像学切除边缘良好。
结论：在了解潜在解剖结构的情况下，可以积极切除SOM。熟悉眼眶可以促进视神经减压术的最大安全切除。
方法：一名75岁女性出现进行性视力丧失和眼球突出。磁共振成像与大，左侧蝶骨翼脑膜瘤，延伸到眶壁，内侧视神经受压。患者选择接受手术切除和视神经减压术。她术后表现良好，眼球突出消退，随访影像学切除边缘良好。
结论：在了解潜在解剖结构的情况下，可以积极切除SOM。熟悉眼眶可以促进视神经减压术的最大安全切除。
