Spheno-Orbital Meningiomas: A Systematic Review of Treatment Modalities, Adjuvant Therapies, and Recurrence Risk

Abstract

Spheno-orbital meningiomas (SOMs) are rare tumors that involve the sphenoid wing and orbit, leading to symptoms such as proptosis and vision loss. Their proximity to critical neurovascular structures complicates surgical resection, making management challenging. A systematic review of 22 paper series involving 1042 patients was conducted using PubMed and Scopus. Studies focused on SOM diagnosis, surgical techniques, recurrence rates, and the role of adjuvant therapies were analyzed. Proptosis and visual impairment were the most common symptoms. Gross total resection (GTR) reduced recurrence, but subtotal resection (STR) often led to higher recurrence, particularly in optic canal involvement. Minimally invasive approaches showed the potential to reduce morbidity. Adjuvant radiotherapy was effective in controlling tumor growth post-STR. SOM management requires a balance between tumor control and functional preservation. While GTR minimizes recurrence, STR with adjuvant radiotherapy is a viable alternative in challenging cases. Minimally invasive techniques offer promise, but further long-term studies are needed.

Keywords: adjuvant radiotherapy; minimally invasive surgery; orbital meningioma; proptosis; surgical resection.

Figure 1. PRISMA flowchart of the included studies.