目的:蝶眶脑膜瘤是罕见的肿瘤,占所有颅内脑膜瘤的9%。患者通常存在眼球突出,和视觉缺陷。这些缓慢生长的肿瘤由于延伸到几个解剖区室而难以切除,导致复发率高达35-50%。尽管开放手术方法历来用于切除,近年来已经报道了一些内窥镜入路。我们旨在回顾文献并描述一例严重视力丧失的蝶眶脑膜瘤,该病例通过内窥镜鼻内入路切除,可实现视觉症状的完全缓解。
方法:根据PRISMA指南对文献进行系统综述。PubMed,科克伦,和WebofScience数据库被查询为通过内窥镜经鼻入路切除的蝶眶脑膜瘤。此外,介绍,手术管理,并描述了一名53岁女性复发性蝶眶脑膜瘤的术后结局。
结果:搜索产生了26篇文章,其中包括8个,产生19例。演示时的平均年龄为60.5岁(范围:44-82岁),68.4%的患者为女性。超过一半的病例实现了次全切除。与鼻内镜手术相关的常见并发症包括CNV2或CNV2/V3感觉减退。手术干预后,大多数患者的视力和视野保持稳定或改善。
结论:内镜方法治疗蝶眶脑膜瘤的势头正在缓慢增长。需要进一步研究这种方法对患者预后和术后并发症的临床益处。
OBJECTIVE: Spheno-orbital meningiomas are rare tumors, accounting for up to 9% of all intracranial meningiomas. Patients commonly present with proptosis, and visual deficits. These slow growing tumors are hard to resect due to extension into several anatomical compartments, resulting in recurrence rates as high as 35-50%. Although open surgical approaches have been historically used for resection, a handful of endoscopic approaches have been reported in recent years. We aimed to review the literature and describe a case of spheno-orbital meningioma with severe vision loss which was resected with an endoscopic
endonasal approach achieving complete resolution of visual symptoms.
METHODS: A systematic review of literature was conducted in accordance with the PRISMA guidelines. PubMed, Cochrane, and Web of Science databases were queried for spheno-orbital meningiomas resected via an endoscopic
endonasal approach. Furthermore, the presentation, surgical management, and post-operative outcomes of a 53-year-old female with a recurrent spheno-orbital meningioma are described.
RESULTS: The search yielded 26 articles, of which 8 were included, yielding 19 cases. Average age at presentation was 60.5 years (range: 44-82), and 68.4% of patients were female. More than half of the cases achieved subtotal resection. Common complications associated with endoscopic
endonasal surgery included CN V2 or CN V2/V3 hypoesthesia. Following surgical intervention, visual acuity and visual field remained stable or improved in the majority of the patients.
CONCLUSIONS: Endoscopic approaches are slowly gaining momentum for treatment of spheno-orbital meningiomas. Further studies on the clinical benefits of this approach on patient outcomes and post-operative complications is warranted.