Newswise — WASHINGTON, D.C. (May 6, 2015) — Winner of the Synthes Skull Base Award, William T. Couldwell, MD, PhD, FAANS, presented findings from the study, Outcomes after Surgical Treatment of Meningioma-associated Proptosis, during the 83rd Annual Scientific Meeting of the American Association of Neurological Surgeons (AANS).

Proptosis (protrusion of the eyeball), associated with sphenoorbital and other skull base meningiomas, can be cosmetically and functionally problematic; however, the literature is limited regarding quantitative proptosis outcomes, with no consensus regarding the optimal surgical technique. This study evaluated proptosis outcomes in order to determine whether an aggressive surgical removal of the periorbital (the tissue around the orbit of the eye) in addition to bone involvement yielded better improvement, and whether this was associated with additional morbidity. No attempt was made to reconstruct the orbit.

The authors reviewed a retrospective cohort of surgeries for meningioma-associated proptosis by a single surgeon. The extent of proptosis resolution was measured by the exophthalmos index (EI) pre- and post- operatively and at final follow-up.

Thirty-two patients (19 female; mean age 49 years) were treated for meningioma-associated proptosis. Twenty had additional visual symptoms, such as a loss of visual acuity, a field cut or diplopia (double vision). None of the patients had worse vision after treatment. Fifteen had improved vision and five had stable vision on follow up (average 33.0 months). Diplopia was present post-operatively but resolved in all cases. No cases of enophthalmos (posterior displacement of the eyeball) were noted. The average pre-operative EI was 1.33, and the average EI at most recent follow-up was 1.01, yielding an average EI improvement of 0.32.

One case of delayed vasospasm was noted. One patient experienced a recurrence of hyperostosis within the treatment zone, which was managed by repeat surgery and post-operative radiation therapy.

Experience from this series indicates that aggressive tumor removal involving the periorbita in cases of meningioma-associated proptosis achieves enhanced cosmetic outcome.

Author Block: Christian A. Bowers, MD

Disclosure: The author reported no conflicts of interest.

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About the 2015 AANS Annual Scientific Meeting: Attended by neurosurgeons, neurosurgical residents, medical students, neuroscience nurses, clinical specialists, physician assistants, allied health professionals and other medical professionals, the AANS Annual Scientific Meeting is the largest gathering of neurosurgeons in the nation, with an emphasis on the field’s latest research and technological advances. More than 1,200 scientific abstracts were presented for review at the 2015 AANS Annual Scientific Meeting, and the scientific presentations given at this year’s event represent cutting-edge examples of the incredible developments taking place within the field of neurosurgery. Additional information about the 2015 AANS Annual Scientific Meeting and the meeting program can be found here.

Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 9,000 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. Fellows of the AANS are board-certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons of Canada, or the Mexican Council of Neurological Surgery, A.C. Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the spinal column, spinal cord, brain, nervous system and peripheral nerves.

For more information, visit www.AANS.org.

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Journal Link: AANS Annual Meeting, May-2015