Microsurgery through fronto-orbital approach for cranio-orbital optic nerve sheath meningiomas (report of 26 cases)

ObjectiveTo explore the clinical effect of microsurgery through fronto-orbital approach on cranio-orbital optic nervesheath meningiomas.MethodThe clinical data of 26 patients with cranio-orbital optic nerve sheath meningiomas who underwentmicrosurgery through fronto-orbital approach in our department from January, 2009 and January, 2014 were analyzed retrospectively.ResultsOf 26 patients, 25 received total resection of the tumors and 1 subtotal. No patients died from the operation, and there were nopostoperative complications such as intracranial infection, cerebrospinal fluid leakage and pulsatile exophthalmus in all the patients. Theeye balls movement disorder occurred after the operation in 4 patients, of whom, 1 were perfectly recovered from the eye balls movementdisorder and 3 partly 3 month after the operation. The ptosis of the eyelids occurred after the operation in 10 patients, of whom, 7 werepartly recovered from the ptosis of the eyelids and 3 not 3 months after the operation. The tissues surrounding the optic canals wereirradiated by γ-knife in 25 patients undergoing the total resection of the tumors and the timorous residue was irradiated by γ-knife in 1patient undergoing the subtotal resection of the tumor after the operation. All the patients were followed up from 3 to 36 months(mean,10.3 months). MRI showed that the tumors did not recur in 25 patients undergoing the total resection of the tumors and the volume of theresidual tumor did not enlarge in 1 patient undergoing the subtotal resection of the tumor during the follow up.Conclusions Microsurgery through the fronto-orbital approach is a good method to treat the cranio-orbital optic nerve sheath meningiomas. Thecurative effect of the microsurgery through the fronto-orbital approach combined with postoperative γ-knife on the cranio-orbital opticnerve sheath meningiomas is satisfactory.