View 2019 Abstracts

Sphenoid wing meningioma (SWM) is a rare condition that may present with optic nerve dysfunction and disfiguring proptosis. This is managed surgically in many centres without the input of an orbital surgeon. The aim of this study is to report the outcomes of a multidisciplinary surgical approach in the treatment of SWM involving the orbit, managed jointly by neurosurgeons, maxillofacial surgeons, and ophthalmologists.

A database of SWM presenting between 2009 to 2019 was obtained consisting of a total of 19 patients. Of these 5 were treated conservatively and 14 were treated surgically. 8 of the surgical patients were operated on by a multidisciplinary approach. Notes were analysed for pre and post-operative optic nerve function, proptosis measurements and complications.

Pre-operatively, the visual acuity (VA) was 6/12 or worse in 50% of patients. Post-operatively only 2 patients dropped their VA by more than 2 Snellen lines (one patient dropped from 6/120 to NPL and other from 6/6 to 6/60). All other patients either improved or maintained their VA. The mean reduction in proptosis was 4mm post-operatively (range 2-9mm). Complications included third nerve palsy in 1 patient, and residual trigeminal neuropathy in 2 patients.

Multi-disciplinary surgical management of SWM allows the combined skill set of allied specialties to be utilised to optimally treat this challenging condition. Our visual outcomes are comparable with other published series.