Hyperostosing meningiomas of the sphenoid wings. Results of surgical treatment in 32 cases

From 1987 to 1995 32 patients were operated on. The orbit was invaded from the tumor in every case and the cavernous sinus in 14. In 30 patients an intradural extension of the lesion was demonstrated. 7 patients were already blind in the involved eye, 8 had marked visual impairment and an oculomotor deficit was associated in 7 patients. Complete neuro radiological removal was obtained in 10 cases; all the patients with cavernous sinus invasion had residual tumor inside the sinus; 4 patients had residual intraorbital lesion. Up to now there has been no recurrence of radically resected meningiomas. while the residual intraorbital component has always regrown. Conversely we did not find any growth of the residual intracavernous component. Oculomotor nerve deficits, when present pre-operatively never improved in our series and improvement of pre-existing visual or campimetric deficits has been unusual. Conversely in 3 patients only the visual functions deteriorated because of the operation. Meticulous precocious aggressive surgery offers the best results in these rare tumors.