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Results of surgical treatment of meningiomas of the brain with proptosis

https://dx.doi.org/10.51350/zdravkg2022.4.10.6.47
Results of surgical treatment of meningiomas of the brain with proptosis
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Abstract About the authors References

Abstract

The purpose of the work. Meningioma-associated proptosis (MAP) can be a cosmetic and functional disorder debilitating for patients with wedge-orbital meningioma and other meningiomas of the base of the skull, and there is limited information on the quantitative improvement of proptosis after surgery. Since less extensive removal of the tumor affecting the orbit cannot reduce proptosis, the senior author adopted an aggressive surgical approach to the removal of the tumor affecting the periorbital and orbit. The authors of this study retrospectively reviewed the results of this surgical approach. Material and methods. All MAP operations performed by one surgeon from January 1, 2010 to May 1, 2020 were reviewed. Age, gender, visual symptoms, number and types of surgical interventions, cavernous sinus lesion, complications, duration of follow-up, residual tumor, use of adjuvant radiation therapy and the degree of resolution of proptosis measured by the exophthalmos index (IE) before and after surgery, as well as at the last observation. Results. Thirty-three patients (24 women - 73%) with an average age of 51.6 years underwent treatment for MAP. Of the 22 patients with additional visual symptoms (for example, loss of visual acuity, reduced field of vision or diplopia), 15 had improved vision, and 7 had stable vision. None of the patients had a worsening of proptosis after treatment. The average preoperative IE was 1.39, the average IE in the immediate postoperative period was 1.23, and the average final IE at the last observation was 1.13. Thus, the average overall improvement in IE was 0.26, but the average immediate decrease in IE was 0.16, demonstrating a progressive improvement in proptosis in the postoperative period. Residual cavernous sinus lesion was present in 17 out of 18 patients who had preoperative cavernous sinus meningioma lesion. Only 2 patients in this series had a recurrent tumor in the eye socket area, and their proptosis improved again after repeated surgery. One case of delayed vasospasm and 2 cases of postoperative trigeminal nerve numbness (V2) were registered. The average follow-up period was 4.5 years (53.8 months). Conclusion. In this series of studies, all patients experienced an improvement in proptosis, and none of them had worse visual symptoms at the last observation, although proptosis disappeared over time. Only 2 patients had a recurrence of the orbit tumor, which required surgical intervention. Surgical complications were rare. The results of the study show that aggressive resection of the MAP is well tolerated and provides excellent elimination of proptosis with infrequent relapses in orbit. It is important to note that there have been no cases of enophthalmos, despite the absence of a formal reconstruction of the orbit.

About the authors

Арстанбеков Нематилла Абдуллаевич, докторант, врач-нейрохирург, кафедры нейрохирургии Кыргызской государственной медицинской академии им. И. К. Ахунбаева,Бишкек, Кыргызская Республика

Ырысов Кенешбек Бакирбаевич, доктор медицинских наук, профессор, член-корр. НАН КР, врач-нейрохирург, кафедры нейрохирургии Кыргызской государственной медицинской академии им. И. К. Ахунбаева,Бишкек, Кыргызская Республика

Arstanbekov Nematilla Abdullaevich, doctoral student, neurosurgeon,Department of Neurosurgery, Kyrgyz State Medical Academy named after I. K. Akhunbaeva, Bishkek, Kyrgyz Republic
Yrysov Keneshbek Bakirbayevich, MD, Professor, Corresponding member National Academy of Sciences of the Kyrgyz Republic, neurosurgeon, Department of Neurosurgery, Kyrgyz State Medical Academy I. K. Akhunbaeva, Bishkek, Kyrgyz Republic

Арстанбеков Нематилла Абдуллаевич, докторант, И. К. Ахунбаев атындагы Кыргыз мамлекетик медициналык академиясынын нейрохирургия кафедрасынын нейрохирург -дарыгери, Бишкек, Кыргыз Республикасы

Ырысов Кенешбек Бакирбаевич, медицина илимдеринин доктору, профессор, КР УИА корр.-мүчөсү,  И. К. Ахунбаев атындагы Кыргыз мамлекетик медициналык академиясынын нейрохирургия кафедрасынын нейрохирург -дарыгери, Бишкек, Кыргыз Республикасы

 

References

1. Adkins W.Y. Jr: Maxillectomy with preservation of orbital function. Surg Forum 27:548-550, 2019.
2. Castellano F., Guidetti B., Olivecrona H.: Pterional meningiomas en plaque. J Neurosurg 9:188-196, 2019.
3. Couldwell W.T., Kan P., Liu J.K.: Decompression of cavernous sinus meningioma for preservation and improvement of cranialnerve function. Technical note. J Neurosurg 105:148-152, 2016.
4. DeMonte F., Tabrizi P., Culpepper S.A.: Ophthalmological outcome after orbital entry during anterior and anterolateral skullbase surgery. J Neurosurg 97:851-856, 2020.
5. Heufelder M.J., Sterker I., Trantakis C.: Reconstructive and ophthalmologic outcomes following resection of spheno- orbitalmeningiomas. Ophthal Plast Reconstr Surg 25:223¬226, 2019.
6. Larson D.L., Christ J.E., Jesse R.H.: Preservation of the orbital contents in cancer of the maxillary sinus. Arch Otolaryngol 108:370-372, 2018.
7. Maroon J.C., Kennerdell J.S., Vidovich D.V.: Recurrent spheno-orbital meningioma. J Neurosurg 80:202¬208, 2014.
8. McCary W.S., Levine P.A.: Management of the eye in the treatment of sinonasal cancers. Otolaryngol Clin North Am 28:1231-1238, 2015.
9. Oya S., Sade B., Lee J.H.: Sphenoorbital meningioma: surgical technique and outcome. J Neurosurg 114:1241-1249, 2017.
10. Ringel F., Cedzich C., Schramm J.: Microsurgical technique and results of a series of 63 spheno-orbital meningiomas. Neurosurgery 60 (4 Suppl 2):214-222, 2018.
11. Saeed P., van Furth W.R., Tanck M.: Surgical treatment of sphenoorbital meningiomas. Br J Ophthalmol 95:996-1000, 2018.
12. Scarone P., Leclerq D., Heran F.: Long-term results with exophthalmos in a surgical series of 30 sphenoorbital meningiomas.Clinical article. J Neurosurg 111:1069-1077, 2019.

1. Adkins W.Y. Jr: Maxillectomy with preservation of orbital function. Surg Forum 27:548-550, 2019.
2. Castellano F., Guidetti B., Olivecrona H.: Pterional meningiomas en plaque. J Neurosurg 9:188-196, 2019.
3. Couldwell W.T., Kan P., Liu J.K.: Decompression of cavernous sinus meningioma for preservation and improvement of cranialnerve function. Technical note. J Neurosurg 105:148-152, 2016.
4. DeMonte F., Tabrizi P., Culpepper S.A.: Ophthalmological outcome after orbital entry during anterior and anterolateral skullbase surgery. J Neurosurg 97:851-856, 2020.
5. Heufelder M.J., Sterker I., Trantakis C.: Reconstructive and ophthalmologic outcomes following resection of spheno- orbitalmeningiomas. Ophthal Plast Reconstr Surg 25:223¬226, 2019.
6. Larson D.L., Christ J.E., Jesse R.H.: Preservation of the orbital contents in cancer of the maxillary sinus. Arch Otolaryngol 108:370-372, 2018.
7. Maroon J.C., Kennerdell J.S., Vidovich D.V.: Recurrent spheno-orbital meningioma. J Neurosurg 80:202¬208, 2014.
8. McCary W.S., Levine P.A.: Management of the eye in the treatment of sinonasal cancers. Otolaryngol Clin North Am 28:1231-1238, 2015.
9. Oya S., Sade B., Lee J.H.: Sphenoorbital meningioma: surgical technique and outcome. J Neurosurg 114:1241-1249, 2017.
10. Ringel F., Cedzich C., Schramm J.: Microsurgical technique and results of a series of 63 spheno-orbital meningiomas. Neurosurgery 60 (4 Suppl 2):214-222, 2018.
11. Saeed P., van Furth W.R., Tanck M.: Surgical treatment of sphenoorbital meningiomas. Br J Ophthalmol 95:996-1000, 2018.
12. Scarone P., Leclerq D., Heran F.: Long-term results with exophthalmos in a surgical series of 30 sphenoorbital meningiomas.Clinical article. J Neurosurg 111:1069-1077, 2019.

1. Adkins W.Y. Jr: Maxillectomy with preservation of orbital function. Surg Forum 27:548-550, 2019.
2. Castellano F., Guidetti B., Olivecrona H.: Pterional meningiomas en plaque. J Neurosurg 9:188-196, 2019.
3. Couldwell W.T., Kan P., Liu J.K.: Decompression of cavernous sinus meningioma for preservation and improvement of cranialnerve function. Technical note. J Neurosurg 105:148-152, 2016.
4. DeMonte F., Tabrizi P., Culpepper S.A.: Ophthalmological outcome after orbital entry during anterior and anterolateral skullbase surgery. J Neurosurg 97:851-856, 2020.
5. Heufelder M.J., Sterker I., Trantakis C.: Reconstructive and ophthalmologic outcomes following resection of spheno- orbitalmeningiomas. Ophthal Plast Reconstr Surg 25:223¬226, 2019.
6. Larson D.L., Christ J.E., Jesse R.H.: Preservation of the orbital contents in cancer of the maxillary sinus. Arch Otolaryngol 108:370-372, 2018.
7. Maroon J.C., Kennerdell J.S., Vidovich D.V.: Recurrent spheno-orbital meningioma. J Neurosurg 80:202¬208, 2014.
8. McCary W.S., Levine P.A.: Management of the eye in the treatment of sinonasal cancers. Otolaryngol Clin North Am 28:1231-1238, 2015.
9. Oya S., Sade B., Lee J.H.: Sphenoorbital meningioma: surgical technique and outcome. J Neurosurg 114:1241-1249, 2017.
10. Ringel F., Cedzich C., Schramm J.: Microsurgical technique and results of a series of 63 spheno-orbital meningiomas. Neurosurgery 60 (4 Suppl 2):214-222, 2018.
11. Saeed P., van Furth W.R., Tanck M.: Surgical treatment of sphenoorbital meningiomas. Br J Ophthalmol 95:996-1000, 2018.
12. Scarone P., Leclerq D., Heran F.: Long-term results with exophthalmos in a surgical series of 30 sphenoorbital meningiomas.Clinical article. J Neurosurg 111:1069-1077, 2019.

Keywords
proptosis , meningioma , skull base , vision , oncology
Для цитирования

Арстанбеков Н.А., Ырысов К.Б. Результаты хирургического лечения менингиом головного мозга с проптозом. Здравоохранение Кыргызстана 2022, № 4, с. 47-53. https://dx.doi.org/10.51350/zdravkg2022.4.10.6.47
For citation

Arstanbekov N. A.,Yrysov K. B. Results of surgical treatment of meningiomas of the brain with proptosis. Health care of
Kyrgyzstan 2022, No.4, pp. 47-53. https://dx.doi.org/10.51350/zdravkg2022.4.10.6.47
Цитата үчүн

Арстанбеков Н.А., Ырысов К.Б.Проптоз менен коштолгон мээнин менингиомаларын хирургиялык дарыло-
онун натыйжалары. Кыргызстандын саламаттык сактоо 2022, no 4, б. 47-53. https://dx.doi.org/10.51350/zdravkg2022.4.10.6.47
Authors Arstanbekov N. A., Yrysov K.B.
Link doi.org https://dx.doi.org/10.51350/zdravkg2022.4.10.6.47
Pages 47-53
Keywords proptosis, meningioma, skull base, vision, oncology
Russian
Об авторах

Арстанбеков Нематилла Абдуллаевич, докторант, врач-нейрохирург, кафедры нейрохирургии Кыргызской государственной медицинской академии им. И. К. Ахунбаева,Бишкек, Кыргызская Республика

Ырысов Кенешбек Бакирбаевич, доктор медицинских наук, профессор, член-корр. НАН КР, врач-нейрохирург, кафедры нейрохирургии Кыргызской государственной медицинской академии им. И. К. Ахунбаева,Бишкек, Кыргызская Республика
Полный текст

PDF (RUS)
Список литературы

1. Adkins W.Y. Jr: Maxillectomy with preservation of orbital function. Surg Forum 27:548-550, 2019.
2. Castellano F., Guidetti B., Olivecrona H.: Pterional meningiomas en plaque. J Neurosurg 9:188-196, 2019.
3. Couldwell W.T., Kan P., Liu J.K.: Decompression of cavernous sinus meningioma for preservation and improvement of cranialnerve function. Technical note. J Neurosurg 105:148-152, 2016.
4. DeMonte F., Tabrizi P., Culpepper S.A.: Ophthalmological outcome after orbital entry during anterior and anterolateral skullbase surgery. J Neurosurg 97:851-856, 2020.
5. Heufelder M.J., Sterker I., Trantakis C.: Reconstructive and ophthalmologic outcomes following resection of spheno- orbitalmeningiomas. Ophthal Plast Reconstr Surg 25:223¬226, 2019.
6. Larson D.L., Christ J.E., Jesse R.H.: Preservation of the orbital contents in cancer of the maxillary sinus. Arch Otolaryngol 108:370-372, 2018.
7. Maroon J.C., Kennerdell J.S., Vidovich D.V.: Recurrent spheno-orbital meningioma. J Neurosurg 80:202¬208, 2014.
8. McCary W.S., Levine P.A.: Management of the eye in the treatment of sinonasal cancers. Otolaryngol Clin North Am 28:1231-1238, 2015.
9. Oya S., Sade B., Lee J.H.: Sphenoorbital meningioma: surgical technique and outcome. J Neurosurg 114:1241-1249, 2017.
10. Ringel F., Cedzich C., Schramm J.: Microsurgical technique and results of a series of 63 spheno-orbital meningiomas. Neurosurgery 60 (4 Suppl 2):214-222, 2018.
11. Saeed P., van Furth W.R., Tanck M.: Surgical treatment of sphenoorbital meningiomas. Br J Ophthalmol 95:996-1000, 2018.
12. Scarone P., Leclerq D., Heran F.: Long-term results with exophthalmos in a surgical series of 30 sphenoorbital meningiomas.Clinical article. J Neurosurg 111:1069-1077, 2019.
Для цитирования

Арстанбеков Н.А., Ырысов К.Б. Результаты хирургического лечения менингиом головного мозга с проптозом. Здравоохранение Кыргызстана 2022, № 4, с. 47-53. https://dx.doi.org/10.51350/zdravkg2022.4.10.6.47
English
About authors

Arstanbekov Nematilla Abdullaevich, doctoral student, neurosurgeon,Department of Neurosurgery, Kyrgyz State Medical Academy named after I. K. Akhunbaeva, Bishkek, Kyrgyz Republic
Yrysov Keneshbek Bakirbayevich, MD, Professor, Corresponding member National Academy of Sciences of the Kyrgyz Republic, neurosurgeon, Department of Neurosurgery, Kyrgyz State Medical Academy I. K. Akhunbaeva, Bishkek, Kyrgyz Republic
References

1. Adkins W.Y. Jr: Maxillectomy with preservation of orbital function. Surg Forum 27:548-550, 2019.
2. Castellano F., Guidetti B., Olivecrona H.: Pterional meningiomas en plaque. J Neurosurg 9:188-196, 2019.
3. Couldwell W.T., Kan P., Liu J.K.: Decompression of cavernous sinus meningioma for preservation and improvement of cranialnerve function. Technical note. J Neurosurg 105:148-152, 2016.
4. DeMonte F., Tabrizi P., Culpepper S.A.: Ophthalmological outcome after orbital entry during anterior and anterolateral skullbase surgery. J Neurosurg 97:851-856, 2020.
5. Heufelder M.J., Sterker I., Trantakis C.: Reconstructive and ophthalmologic outcomes following resection of spheno- orbitalmeningiomas. Ophthal Plast Reconstr Surg 25:223¬226, 2019.
6. Larson D.L., Christ J.E., Jesse R.H.: Preservation of the orbital contents in cancer of the maxillary sinus. Arch Otolaryngol 108:370-372, 2018.
7. Maroon J.C., Kennerdell J.S., Vidovich D.V.: Recurrent spheno-orbital meningioma. J Neurosurg 80:202¬208, 2014.
8. McCary W.S., Levine P.A.: Management of the eye in the treatment of sinonasal cancers. Otolaryngol Clin North Am 28:1231-1238, 2015.
9. Oya S., Sade B., Lee J.H.: Sphenoorbital meningioma: surgical technique and outcome. J Neurosurg 114:1241-1249, 2017.
10. Ringel F., Cedzich C., Schramm J.: Microsurgical technique and results of a series of 63 spheno-orbital meningiomas. Neurosurgery 60 (4 Suppl 2):214-222, 2018.
11. Saeed P., van Furth W.R., Tanck M.: Surgical treatment of sphenoorbital meningiomas. Br J Ophthalmol 95:996-1000, 2018.
12. Scarone P., Leclerq D., Heran F.: Long-term results with exophthalmos in a surgical series of 30 sphenoorbital meningiomas.Clinical article. J Neurosurg 111:1069-1077, 2019.
For citation

Arstanbekov N. A.,Yrysov K. B. Results of surgical treatment of meningiomas of the brain with proptosis. Health care of
Kyrgyzstan 2022, No.4, pp. 47-53. https://dx.doi.org/10.51350/zdravkg2022.4.10.6.47
Kyrgyz
Авторлор жөнүндө

Арстанбеков Нематилла Абдуллаевич, докторант, И. К. Ахунбаев атындагы Кыргыз мамлекетик медициналык академиясынын нейрохирургия кафедрасынын нейрохирург -дарыгери, Бишкек, Кыргыз Республикасы

Ырысов Кенешбек Бакирбаевич, медицина илимдеринин доктору, профессор, КР УИА корр.-мүчөсү,  И. К. Ахунбаев атындагы Кыргыз мамлекетик медициналык академиясынын нейрохирургия кафедрасынын нейрохирург -дарыгери, Бишкек, Кыргыз Республикасы

 
Шилтемелер

1. Adkins W.Y. Jr: Maxillectomy with preservation of orbital function. Surg Forum 27:548-550, 2019.
2. Castellano F., Guidetti B., Olivecrona H.: Pterional meningiomas en plaque. J Neurosurg 9:188-196, 2019.
3. Couldwell W.T., Kan P., Liu J.K.: Decompression of cavernous sinus meningioma for preservation and improvement of cranialnerve function. Technical note. J Neurosurg 105:148-152, 2016.
4. DeMonte F., Tabrizi P., Culpepper S.A.: Ophthalmological outcome after orbital entry during anterior and anterolateral skullbase surgery. J Neurosurg 97:851-856, 2020.
5. Heufelder M.J., Sterker I., Trantakis C.: Reconstructive and ophthalmologic outcomes following resection of spheno- orbitalmeningiomas. Ophthal Plast Reconstr Surg 25:223¬226, 2019.
6. Larson D.L., Christ J.E., Jesse R.H.: Preservation of the orbital contents in cancer of the maxillary sinus. Arch Otolaryngol 108:370-372, 2018.
7. Maroon J.C., Kennerdell J.S., Vidovich D.V.: Recurrent spheno-orbital meningioma. J Neurosurg 80:202¬208, 2014.
8. McCary W.S., Levine P.A.: Management of the eye in the treatment of sinonasal cancers. Otolaryngol Clin North Am 28:1231-1238, 2015.
9. Oya S., Sade B., Lee J.H.: Sphenoorbital meningioma: surgical technique and outcome. J Neurosurg 114:1241-1249, 2017.
10. Ringel F., Cedzich C., Schramm J.: Microsurgical technique and results of a series of 63 spheno-orbital meningiomas. Neurosurgery 60 (4 Suppl 2):214-222, 2018.
11. Saeed P., van Furth W.R., Tanck M.: Surgical treatment of sphenoorbital meningiomas. Br J Ophthalmol 95:996-1000, 2018.
12. Scarone P., Leclerq D., Heran F.: Long-term results with exophthalmos in a surgical series of 30 sphenoorbital meningiomas.Clinical article. J Neurosurg 111:1069-1077, 2019.
Цитата үчүн

Арстанбеков Н.А., Ырысов К.Б.Проптоз менен коштолгон мээнин менингиомаларын хирургиялык дарыло-
онун натыйжалары. Кыргызстандын саламаттык сактоо 2022, no 4, б. 47-53. https://dx.doi.org/10.51350/zdravkg2022.4.10.6.47
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