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Graefe's Archive for Clinical and Experimental Ophthalmology

Open Access 19-03-2024 | Meningioma | Oncology

Gross-total resection in optic nerve sheath meningiomas: minimally invasive and cosmetic pleasing

Authors: Qin Dai, Xinyu Li, Yenan Fang, Bingyan Shen, Jinfei Wei, Qiqi Xie, Wencan Wu, Min Wang

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology

Abstract

Purpose

The optic nerve sheath meningioma (ONSM) is one of the most challenging tumors in orbital surgery. From the perspective of mental health and patient needs, we analyzed the necessity and importance of the endoscopic transnasal approach (ETA) combined with optic nerve transection (ONT) in gross-total resection (GTR) in ONSM patients with residual vision and aim to broaden the use of ONT for specific people.

Methods

The authors included patients with ONSMs who were treated between 2014 and 2022. We divided those cases into two groups named ETA group and lateral orbitotomy approach (LOA) group. We present the application of ETA and analyze the preoperative indication of the ONT and compared the advantages and disadvantages between ETA and LOA. The degree of tumor resection was based on imaging and surgical evaluation.

Results

A total of 23 patients with ONSM were included. Sixteen patients underwent ETA, and seven underwent LOA. Among ETA cases, GTR was achieved in 14 patients with ONT and most patients maintained normal eye movement function (75%) and morphology (93.75%). In the ETA group, 14 patients experienced vision loss, while two other patients saw improvements in vision. And proptosis was alleviated (5.20 ± 2.34 vs 0.27 ± 0.46, p < 0.0001). Six patients with blindness and proptosis of the LOA group resulted in GTR with ONT and ophthalmectomy. Although intracranial extension and recurrence included no cases in the two groups, a significant psychological gap was presented due to cosmetic problems.

Conclusions

Under the premise of reducing damage and improving aesthetics, the selection of ETA combined with ONT to gross-total resect ONSMs successfully provides a minimally invasive access with acceptable complications. As an important adjunct to GTR in the surgical treatment of ONSM, the scope of ONT application should be expanded to relieve the patient’s psychological burden.

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Title: Gross-total resection in optic nerve sheath meningiomas: minimally invasive and cosmetic pleasing
Authors: Qin Dai
Xinyu Li
Yenan Fang
Bingyan Shen
Jinfei Wei
Qiqi Xie
Wencan Wu
Min Wang
Publication date: 19-03-2024
Publisher: Springer Berlin Heidelberg
Keywords: Meningioma
Meningioma
Orbitotomy
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-024-06447-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Gross-total resection in optic nerve sheath meningiomas: minimally invasive and cosmetic pleasing

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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