Orbital Reconstruction after Spheno-Orbital Meningiomas Excision with Fascia Lata and Fat Graft | ||||
| Ain Shams Medical Journal | ||||
| Volume 76, Issue 2, June 2025, Page 495-506 PDF (682.7 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/asmj.2025.373047.1429 | ||||
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| Authors | ||||
George Halim Korkar 1; Mazen Thabet Alkarras  2; Mina Mounir Rizk3; Basma Hassan El Saied 4; Abdelmaksod Mohammed Mousa 5
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| 1Department of Neurosurgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt | ||||
| 2Neurosurgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt | ||||
| 3Department of Neurosurgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt. | ||||
| 4Department of Anesthesiology, Intensive Care, and Pain Therapy, Faculty of Medicine, Ain Shams University, Cairo, Egypt | ||||
| 5Neurosurgery Department, Faculty of Medicine, October 6 University, Giza, Egypt | ||||
| Abstract | ||||
| Background: Spheno-orbital meningioma (SOM) is a very rare subtype of meningioma which arises from the sphenoid ridge with an orbital extension which results in painless proptosis and slowly progressing visual impairment. Methods: Observational retrospective study evaluates the efficacy and safety of orbital reconstruction using fascia lata , fat graft, and titanium mesh following SOM excision between January 2019 and January 2022. Postoperative follow-up, conducted over one year, monitored proptosis improvement, enophthalmos, and complications. Results: 14 patients with SOMs met the inclusion criteria, consisting of 9 females and 5 males with a mean age of 48.29±5.86 years. All patients presented with proptosis, and preoperative EI averaged 1.27±0.08. Postoperatively, proptosis improved in all patients, with 50% achieving complete resolution. The mean postoperative EI significantly decreased to 1.051±0.06 (p<0.001). Visual acuity improved in 50% of patients, with temporary deterioration observed in 1 patient (7.1%) (p<0.001). Ocular motility improved in 35.7% of patients (p=0.001). Gross total resection was achieved in 7 patients (50%), while the remaining 7 underwent subtotal resection. No CSF leakage occurred, although two patients (14.3%) experienced CSF collection, which resolved conservatively. Over one year of follow-up, no enophthalmos developed, and 85.7% of patients were satisfied with cosmetic outcomes. Conclusions: Surgical resection of SOM is effective in stopping the evolution of the visual deficit and improving proptosis. Orbital reconstruction with fascia lata and fat graft along with titanium mesh gives the best results regarding the prevention of CSF leakage or collection with long-term prevention of enophthalmos with better cosmetic results. | ||||
| Keywords | ||||
| Exophthalmos index; orbital reconstruction; spheno-orbital meningioma | ||||
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