Results of surgical removal of optic nerve sheath meningioma
Objective – to study the features of surgical technique and to analyze the results of treatment of patients with optic nerve sheath meningioma (ONSM).
Materials and methods. A retrospective analysis of surgical treatment of 8 patients (5 men, 3 women) with ONSM, that were hospitalized and operated in the neurosurgical department in Kyiv Municipal Clinical Emergency Hospital from 2000 till 2015.
Results. Preoperative visual activity in 3 (37.5 %) patients were above 0.5 D, 3 (37.5 %) - 5-0.1 D and 2 (25 %) patients were almost blind (visual acuity 0.1-0 D). Two patients had proptosis (less than 4 mm). Diplopia was detected in 3 (37.5 %) patients, visual field defects in 2 patients, oculomotor disorders in 3 patients, ptosis in 1 case. Standard pterional approach with optic decompression was performed in 7 (87.5 %) patients. One patient had combined intra-and extradural approach with intradural optic nerve revision. In 5 (62.5 %) cases total resection was performed, in 3 (37.5 %) – subtotal. At discharge, visual acuvity did not differ from the preoperative state in 6 (75 %) patients, 2 (25 %) patients vision deteriorated. Regression of proptosis in the postoperative period was observed in 2 patients. Two patients noted ptosis and diplopia after surgery.
Conclusions. In the absence of vision loss, patients may be observed with ophthalmologic examination and routine contrast magnetic resonance imaging. Surgery with optic nerve decompression and intracranial tumor resection is performed in cases of intracranial and intracranial extension.
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