Affiliation:
1. Division of Neurosurgery, Department of Neurosciences and Reproductive and Odontostomatological Sciences Federico II University of Naples Naples Italy
2. Division of Maxillofacial Surgery Unit, Department of Neurosciences and Reproductive and Dental Sciences Federico II University of Naples Naples Italy
Abstract
AbstractBackgroundSphenoorbital meningiomas (SOM) harbor intrinsic features that render their surgical management and the reconstruction of the resulting bony defect overtly challenging.MethodsA 70‐year‐old woman, harboring a long‐standing left frontotemporal bony swelling conservatively managed, presented with progressive left proptosis. Radiological features were consistent with an en plaque SOM. A one‐step multiportal transcranial and endoscopic transorbital approach (TOA) with custom bone three‐dimensional (3D) printing reconstruction using polymethylmethacrylate (PMMA) was scheduled.ResultsPostoperative functional and aesthetic results were excellent, with proptosis and calvarian deformity resolution. Tumor subtotal resection was achieved. Histopathological diagnosis confirmed a transitional meningioma (WHO grade I).ConclusionsThe endoscopic TOA, isolated or as part of a multiportal strategy, has entered the surgical armamentarium for the treatment of SOMs. A customized PMMA cranioplasty can be considered a possible option for the reconstruction of large bony defects in a one‐step fashion.