Microsurgical resection of cranial orbital communicating meningioma and reconstruction of skull base

doi:10.3969/j.issn.1671-2897.2003.02.003

Abstract：Objective This study is aimed at exploring the diagnosis, surgical resection, and prognosis ofthe cranial orbital communicating meningiomas (COCM). Methods Among 11 patients with cranio-orbitalcommunicating neoplasms admitted to our hospital from February 1998 to December 2000, altogether 5 casesdiagnosed pathologically as meningiomas were summarized and analyzed on the aspects of clinical manifestations,image changes, operative manipulation, morphological characteristics, and prognosis. Results Subfrontal orfronto-temporal lateral approach was performed, with purely epidural resection in 3 cases, and combination ofepidural and subdural resection in 2 cases. Total removal was achieved in 4 cases, subtotal in 1 case. Bonereconstruction at cranial base was performed in all patients. Of the 2 patients who had normal visual acuity,lightreaction, and ocular movement preoperatively, 1 case presented severely declined vision and inert light reactionpostoperatively. In the follow-up period, all cases did not undergo radiation therapy, and 2 cases recurred whohad been demonstrated to have lots of fibroblastic cells in tumor tissue on their postoperative pathologicalexamination. Conclusion COCM invades many vital anatomical structures in cranio-orbital junction, and tends torecur. Perfect exposure and radical removal, skull base reconstruction, and postoperative radiotherapy should bemuch emphasized in dealing with this disease.