Reconstructive and Ophthalmologic Outcomes Following Resection of Spheno-Orbital Meningiomas

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Abstract
Purpose: To assess long-term stability and aesthetic and functional outcomes of orbital reconstruction after resection of spheno-orbital meningiomas using calvarial bone grafts. Methods: A series of 21 patients were retrospectively examined after an average follow-up period of 65.6 months with regard to their personal satisfaction and also proptosis, ocular function, and reconstructive outcome. The sagittal position of the globe was analyzed by CT and MRI. Patients were treated surgically in an interdisciplinary approach between 1997 and 2006. Results: A permanent postoperative decrease in globe protrusion of 2.7 mm on average was achieved. Most patients (76%) reported identical or improved vision, 85% were satisfied with the reconstructive result, and 55% were free of discomfort in daily life. Seven patients suffered from recurrences that were invariably accompanied by globe protrusion. Conclusions: Calvarial bone grafts provide good, stable long-term results in the reconstruction of orbital defects. Globe protrusion is a reliable indicator for the detection of recurrences in spheno-orbital meningiomas. Because of high recurrence rates, it is advisable to continue follow-up for 20 or more years.