Skull Base 2009; 19(2): 163-170
DOI: 10.1055/s-0028-1096199
CASE REPORT

© Thieme Medical Publishers

Spheno-orbital Reconstruction after Meningioma Resection

Michael B. Pritz1 , Richard A. Burgett2
  • 1Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana
  • 2Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana
Further Information

Publication History

Publication Date:
29 October 2008 (online)

ABSTRACT

This report details a technique for spheno-orbital reconstruction after meningioma resection. The approach uses a life-size skull model generated from a thin-slice craniomaxillofacial computed tomogram. On this skull model, the planned area of bone removal of the involved orbit and sphenoid is outlined on the normal side opposite the lesion. A three-dimensional implant is then generated by reversing the anticipated area of bone resection on the normal side to create a mirror-image implant. This technique resulted in minimal intraoperative implant contouring, decreased surgical time, and satisfactory functional and cosmetic outcome.

REFERENCES

  • 1 Maroon J C, Kennerdell J S, Vidovich D V, Abla A, Sternau L. Recurrent spheno-orbital meningioma.  J Neurosurg. 1994;  80 202-208
  • 2 Shick U, Bleyen J, Bani A, Hassler W. Management of meningiomas en plaque of the sphenoid wing.  J Neurosurg. 2006;  104 208-214
  • 3 Shrivastava R K, Sen C, Constantino P D, Della Rocca R. Sphenoorbital meningiomas: surgical limitations and lessons learned in their long-term management.  J Neurosurg. 2005;  103 491-497
  • 4 Carrizo A, Basso A. Current surgical treatment for sphenoorbital meningiomas.  Surg Neurol. 1998;  50 574-578
  • 5 Brusati R, Biglioli F, Mortini P, Raffaini M, Goisis M. Reconstruction of the orbital walls in surgery of the skull base for benign neoplasms.  Int J Oral Maxillofac Surg. 2000;  29 325-330
  • 6 Kelly C P, Cohen A J, Yavuzer R, Jackson I T. Cranial bone grafting for orbital reconstruction: is it still the best?.  J Craniofac Surg. 2005;  16 181-185
  • 7 Leake D, Gunnlaugsson C, Urban J, Marentette L. Reconstruction after resection of sphenoid wing meningiomas.  Arch Facial Plast Surg. 2005;  7 99-103
  • 8 Evans B T, Neil-Dwyer G, Lang D. Reconstruction following extensive removal of meningioma from around the orbit.  Br J Neurosurg. 1994;  8 147-155
  • 9 Columella F, Testa C, Andreoli A. Radical resection and reconstruction in spheno-ethmoidal-orbital tumors. Report of 3 cases.  J Neurosurg Sci. 1974;  18 198-205
  • 10 Bikmaz K, Mrak R, Al-Mefty O. Management of bone-invasive, hyperostotic sphenoid wing meningiomas.  J Neurosurg. 2007;  107 905-912
  • 11 Katano H, Aihara N, Takeuchi Y, Nozaki M, Yamada K. Tailor-made orbitocranioplasty for a sphenorbital encephalocele presenting as pulsatile exophthalmos: case report.  J Neurosurg. 2007;  106(2 suppl) 126-130
  • 12 Metzger M C, Schön R, Schmelzeisen R. Preformed titanium meshes: a new standard?.  Skull Base. 2007;  17 269-272
  • 13 Ringel F, Cedzich C, Schramm J. Microsurgical technique and results of a series of 63 spheno-orbital meningiomas.  Neurosurgery. 2007;  60(4 suppl 2) 214-222 discussion 221-222
  • 14 Westendorff C, Kaminsky J, Ernemann U, Reinert S, Hoffman J. Image-guided sphenoid wing meningioma resection and simultaneous computer-assisted cranio-orbital reconstruction: technical case report.  Neurosurgery. 2007;  60(2 suppl 1) ONSE173-174 discussion ONSE174
  • 15 Eppley B L. Craniofacial reconstruction with computer-generated HTR patient-matched implants: use in primary bony tumor excision.  J Craniofac Surg. 2002;  13 650-657
  • 16 Biomet microfixation implant information sheet. Biomet Web site. Available at: http://www.biometmicrofixation.com Accessed May 1, 2008
  • 17 Bou-Assaly W, Illner A, Mosier K M, Kalnin A, Pritz M B. Intra-osseous meningioma of the orbit: an unusual presentation.  Eur Radiol. 2007;  17 2192-2194

Michael B PritzM.D. Ph.D. 

Department of Neurological Surgery, Indiana University School of Medicine, 545 Barnhill Drive

Emerson 141, Indianapolis, IN 46202-5124

Email: mpritz@iupui.edu