Sphenoid wing meningioma en plaque: A clinical review

Objective. To review the role of craniofacial resection and reconstruction in the treatment of patients with sphenoid wing meningioma en plaque. Design. 15 patients were reviewed. The presenting features, operative detai ls and complications were documented. The adequacy of resection was reviewe d and postoperative scans were analyzed to assess orbital reconstruction. P atients were assessed regarding aesthetics and craniofacial function. The G lasgow outcome scale and the SF36 questionnaire were used to assess outcome . Results. The majority (92%) presented with proptosis and had disease extend ing from the sphenoid wing into the orbital roof (71%) and the middle Fossa (71%). The transzygomatic approach was the most commonly used approach (85 %). 14 patients were examined on an outpatient basis, one patient has died. In the majority of patients visual acuity was unchanged (85%) and in most cases (85%) there was significant improvement in globe position. Ptosis (57 %) and upper eyelid swelling (50%) were a persistent problem. Craniofacial function and cosmesis were well maintained. Two patients have had clinical recurrences (14%). 14 have had a good outcome adjudged by the Glasgow outco me scale and most patients have satisfactory outcomes adjudged by the SF36 questionnaire. Conclusions. Meningioma en plaque represents a difficult surgical challenge requiring a multidisciplinary approach. By using well established craniofa cial techniques good disease control can be achieved with minimal morbidity and good functional and cosmetic results.