Surgical Management of Extracranial Meningiomas Arising in the Head and Neck

Publication date: Available online 24 March 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Moustafa Mourad, David Chan, Yadranko Ducic
ObjectiveTo determine outcomes in the management of extracranial meningiomas of the head and neck.Study DesignRetrospective single surgeon series.SettingTertiary Care Referral Center.Subjects and MethodsIn all, 23 patients met inclusion criteria, consisting of 12 males and 11 females. The average age of patients treated was 60.5 years (range 32-71). Subsite involvement included the infratemporal fossa (8), greater wing of sphenoid and orbit (7), clivus (2), and the parapharyngeal space (6).ResultsIn all recurrence occurred in 21% (5) patients that had gross tumor resection. Two patients underwent subtotal resection due to tumor location within the clivus with adjuvant cyberknife therapy. Both patients had persistent disease with no new neurological symptoms. Examination revealed that 100% (23) of patients had dural involvement. Post-ablative complications occurred in 43% (10) patients.ConclusionsWe presently report the largest series of surgical treatment for extracranial meningiomas. Gross tumor resection should be the mainstay of therapy, except in anatomically restricted regions such as the petrous apex and clivus. Adjuvant therapy including cyberknife therapy may be used in such lesions. All lesions demonstrated dural involvement. A more unified nomenclature is required for the characterization of these lesions.



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