Meningiomas Involving the Orbit: Surgical Technique and a Series of 17 Patients Operated between 2004 and 2007

Purpose: Meningiomas originating from different locations may involve the orbit, such as primary orbital meningioma, spheno-orbital meningiomas, olfactory groove meningioma, and others. Surgical removal of the orbital component of these tumors presents a unique surgical difficulty with potential damage to the orbital structures. We report a series of 17 patients with meningiomas involving the orbit, and focus on the surgical technique and visual outcome of these patients.

Methods: We performed a retrospective analysis using patient files from the hospital and the outpatient clinic, operative notes, and pre- and postoperative imaging studies. We also included the visual outcome before and after surgery.

Results: There were 12 females and 5 males aged 19 to 86 (mean, 48 years). Sixteen of the 17 patients presented with intracranial or orbital complications: orbital pain (3), headaches (3), proptosis (9), and rapid visual deterioration (7). Surgical technique and reconstruction is discussed. We achieved complete removal of the tumor in 10 cases, subtotal removal in 6 cases and a biopsy in 1 patient. Vision did not deteriorate in any of our patients.

Conclusions: Meningiomas involving the orbit can have serious complications including orbital and intracranial symptomatology. Our experience shows that these lesions are resectable using skull base approaches with good visual and orbital function and with generally few complications.