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Open Access 01-11-2019 | Meningioma | Original Article - Tumor - Meningioma

Challenging the osseous component of sphenoorbital meningiomas

Authors: Svenja Maschke, Mauricio Martínez-Moreno, Alexander Micko, Matthias Millesi, Georgi Minchev, Ammar Mallouhi, Engelbert Knosp, Stefan Wolfsberger

Published in: Acta Neurochirurgica | Issue 11/2019

Abstract

Background

Intraosseous growth is a unique feature of sphenoorbital meningiomas (SOM). Its close relation to neurovascular structures limits complete surgical resection and possibly contributes to the high recurrence rate.

Objective

To evaluate the growth behavior of intraosseous remnants and develop a protocol for precise intraoperative visualization of intraosseous SOM.

Methods

We included 31 patients operated for SOM from 2004 to 2017. The growth velocity of the intraosseous tumor component was volumetrically calculated in 20 cases. To improve accuracy of image guidance, we implemented a specialized bone surface-based registration algorithm. For intraoperative bone visualization, we included CT in multimodality continuous image guidance in 23 patients. The extent of resection (EOR) was compared with a standard MR-only navigation group (n = 8).

Results

In 11/20 cases (55%), a progressive regrowth of the intraosseous SOM remnant was noted during a mean follow-up of 52 months (range 20–132 months). We observed a mean increase of 6.2 cm³ (range 0.2–23.7 cm³) per patient and side during the follow-up period. Bone surface-based registration was significantly more accurate than skin surface-based registration (mean 0.7 ± 0.4 mm and 1.9 ± 0.7 mm, p < 0.001). The EOR of the intraosseous component was significantly higher using CT + MRI navigation compared with controls (96% vs. 81%, p = 0.044).

Conclusion

Quantitative assessment of the biological behavior of intraosseous remnants revealed a continuous slow growth rate independent of the soft tumor component of more than half of SOM. According to our data, application of a multimodal image guidance provided high accuracy and significantly increased the resection rate of the intraosseous component of SOM.

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Title: Challenging the osseous component of sphenoorbital meningiomas
Authors: Svenja Maschke
Mauricio Martínez-Moreno
Alexander Micko
Matthias Millesi
Georgi Minchev
Ammar Mallouhi
Engelbert Knosp
Stefan Wolfsberger
Publication date: 01-11-2019
Publisher: Springer Vienna
Keywords: Meningioma
Meningioma
Published in: Acta Neurochirurgica / Issue 11/2019
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-019-04015-y

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Springer Medicine

Challenging the osseous component of sphenoorbital meningiomas

Abstract

Background

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusion

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