[Orbitosphenopetroclival meningeomas: clinical and topographic features and results of combined treatment]. / Orbitosfenopetroklival'nye meningiomy: kliniko-topo-grafi-cheskie osobennosti i rezul'taty kombinirovannogo lecheniia.

ABSTRACT

UNLABELLED The aim of the study was to access clinical and topographic features of orbitosphenopetroclival meningeomas and the results of surgical and combined treatment in patients with meningeaomas of that location. Orbitosphenopetroclival meningeomas comprise a peculiar group of tumors and are the result of infiltrative sphenopetroclival meningeomas progression, when the latter extend into the orbit and temporal fossa. Development of neurosurgery, use modern approaches and adjuvant therapies such as stereotaxic radiosurgery and radiotherapy in the past years markedly improve treatment results in these patients. However, difficulties in treatment strategy choice remain. One attempting to excise a tumor radically encounters with the risk of damage to critically important neurovascular structures. When a tumor is excised partially the risk of complication dwindles, however risk of relapse increases. Palliative surgery improve patients' quality of life. Radiosurgery and irradiation of residual tumors allow to establish control on a tumor growth. MATERIAL AND METHODS: Twenty three patients were studied, of them 20 received surcery, 9 - stereotaxic irradiation, 5 - conventional irradiation. The follow-up interval comprised 8-84 months (median 37 months). RESULTS: Manifestations of orbitosphenopetroclival meningeomas are combined from signs and symptoms of cranioorbital and petroclival meningeomas, and in many patients include signs of skull base external surface involvemevt, marked cosmetic deficits and psychological distress. Orbitosphenopetroclival meningeomas originate from cavernous sinus and medial parts of sphenoid bone wings. During its progression a tumor extends onto orbit and onto clivus, and then onto infratemporal and sphenopalatine fossae, nasopharynx and posterior cranial fossa. CONCLUSION: If a residual tumor is present patients with orbitosphenopetroclival meningeomas should undergo adjuvant irradiation after the first surgery.