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. 2023 Sep 8;12(18):5840. doi: 10.3390/jcm12185840

Table 1.

Summary of studies included in the systematic literature review and meta-analysis. (CN = cranial nerve; GTR = gross total resection; NA = not available; RT = radiotherapy).

Study Baseline
Data
Presentation Treatment Mean
Follow-Up Time (Months)
No. Author, Journal, Year Title Country Prospective/Retrospective Study
Period
Sample Size Mean Age at Intervention (range) F (%) WHO Grade (No.) Visual Acuity Decrease No. (%) CN Deficits (III, IV, VI) No. (%) Proptosis No. (%) Others No. (%)
of GTR
No. (%) of Patients Receiving
Post-op RT
1 Bonnal [8],
J Neurosurg, 1980
Invading Meningiomas of the Sphenoid Ridge Belgium Retrospective 1958–1979 21 45 (23–65) 81% NA 8 (38%) 3 (14%) 11 (52%) Epilepsy,
hemiparesis, aphasia,
headache,
intracranial
hypertension, visual field
deficit, Foster Kennedy
syndrome, deafness,
5th and 6th nerve palsy
NA NA NA
2 Maroon [9],
J Neurosurg,
1994
Recurrent Spheno-Orbital Meningioma USA Retrospective 1975–1992 15 46 73% NA 6 (40%) 2 (13%) 13 (87%) Blindness,
visual field
deficit,
V1 hypesthesia
9 (60%) 10 (67%) NA
3 Gaillard [10],
Plastic and Reconstructive Surgery, 1997
Strategy of Craniofacial Reconstruction After
Resection of Spheno-Orbital “en Plaque” Meningiomas
France Retrospective 1981–1993 20 NA NA NA NA 2 (10%) NA NA NA NA 84
4 De Jesus [11],
Surg Neurol, 2001
Surgical Management of Meningioma en Plaque of the Sphenoid Ridge Puerto Rico Retrospective 1990–1997 6 51 (39–64) 100% NA 3 (50%) NA 5 (83%) Seizure 5 (83%) NA 48
5 Leake [12], Arch Facial Plast Surg, 2005 Reconstruction after
Resection of Sphenoid Wing Meningiomas
USA Retrospective 1995–2004 22 53 (31–73) 77% NA 5 NA 15 (68%) Visual field deficit,
trigeminal
hypoesthesia, seizure,
dysphagia
11 (50%) 4 (18%) 15
6 Roser [13], Surg Neurol, 2005 Sphenoid Wing Meningiomas with
Osseous Involvement
Germany Retrospective NA 82 53 (21–78) 77% NA 18 (22%) 2 (2%) 31 (38%) Headache, aphasia,
trigeminal
neuralgia,
seizure
31 (38%) NA 66
7 Shrivastava [14],
J. Neurosurg, 2005
Spheno-Orbital Meningiomas: Surgical Limitations and
Lessons Learned in Their Long-Term Management
USA Retrospective 1991–2003 25 51 (22–76) 88% NA 20 (80%) 5 (20%) 22 (88%) Trigeminal
hypoesthesia, scotoma
18 (70%) 2 (8%) 60
8 Sandalcioglu [15],
Journal of Cranio-
Maxillofacial Surgery, 2005
Spheno-orbital Meningiomas: Interdisciplinary Surgical Approach, Resectability and Long-Term
Results
Germany Retrospective 1998–2002 16 53 (3–76) 94% I 7 (44%) 1 (6%) 14 (88%) Diplopia 16 (100%) 2 (13%) 68
9 Schick [16],
J Neurosurg, 2006
Management of Meningiomas en Plaque of the Sphenoid Wing Germany Retrospective 1991–2002 67 58 (32–79) 79% I (64), II (3) 28 (42%) 11 (16%) 33 (49%) V palsy,
visual field
deficit
40 (60%) 5 (7%) 46
10 Ringel [17], Operative Neurosurg, 2006 Microsurgical Technique and
Results of a
Series
of 63 Spheno-orbital Meningiomas
Germany Retrospective 1983–2003 63 51 (21–77) 79% NA 28 (44%) 16 (25%) 50 (79%) Visual field deficit,
seizure,
diplopia
45 (71%) NA 54
11 Bikmaz [18], J Neurosurg, 2007 Management of Bone-Invasive, Hyperostotic Sphenoid Wing Meningiomas USA Retrospective 1994–2004 17 52 (36–70) 88% NA 10 (59%) 3 (18%) 12 (71%) Eye swelling, headache,
incidental,
diplopia
14 (82%) NA 36
12 Yong [19], Chin Med J (Engl),
2009
Sphenoid Wing Meningioma en Plaque: Report of 37 Cases China Retrospective 1998–2009 37 46 (16–67) 59% I (33), II (2), III (2) 26 (70%) NA 37 (100%) Headache,
seizure
9 (24%) 10 (27%) 36
13 Scarone [20], J Neurosurg, 2009 Long-Term
Results with Exophthalmos in a Surgical Series
of 30 Spheno-Orbital Meningiomas
France Retrospective 1994–2005 30 51 (35–74) 100% NA 6 (20%) NA 28 (93%) Headache,
temporal
swelling,
visual field
deficit
27 (90%) 1 (3%) NA
14 Heufelder [21],
Ophthalmic Plastic and Reconstructive Surgery, 2009
Reconstructive and Ophthalmologic Outcomes Following Resection of Spheno-Orbital Meningiomas Germany Retrospective 1997–2006 21 61 (47–81) 95% I (19), II (2) NA NA 18 (86%) Visual field deficit, epiphora NA 5 (24%) 66
15 Mirone [22], Neurosurgery, 2009 En Plaque Sphenoid Wing Meningiomas: Recurrence Factors and Surgical Strategies in
a Series of 71
Patients
France Retrospective 1986–2006 71 53 (12–79) 87% I 41 (58%) 15 (21%) 61 (86%) Diplopia,
headache,
trigeminal pain, visual field
deficit,
chemosis,
seizure
59 (83%) 1 (1%) 77
16 Cannon [5], Orbit,
2009
The Surgical Management and Outcomes for Spheno-Orbital Meningiomas: A 7-Year Review of Multi-Disciplinary Practice UK Retrospective 2000–2007 12 51 (34–64) 92% I (11), II (1) 5 (42%) 1 (8%) 12 (100%) Diplopia NA 3 (25%) 31
17 Civit [23], Neuro-
chirurgie,
2010
Spheno-Orbital Meningiomas France Retrospective NA 41 NA NA NA 23 (56%) 4 (9%) 39 (95%) V deficit,
visual field
deficit
NA NA NA
18 Honig [24], Neurological research, 2010 Spheno-Orbital Meningiomas: Outcome After
Microsurgical Treatment: A Clinical Review of 30 Cases
Germany Retrospective 2001–2006 30 54 (25–74) 73% I (26), II (3), III (1) 22 (73%) 6 (20%) 16 (53%) Diplopia,
headache,
trigeminal pain, visual field
deficit,
chemosis,
seizure
10 (33%) 8 (27%) 34
19 Oya [25],
J Neurosurg, 2011
Spheno-Orbital Meningioma: Surgical Technique and Outcome USA Retrospective 1994–2009 39 49 (33–68) 87% NA 21 (54%) 3 (8%) 39 (100%) Diplopia,
headache,
trigeminal pain, visual field
deficit
15 (38%) 4 (10%) 41
20 Luetjens [26],
Clin Neurol Neurosurg, 2011
Bilateral Spheno-Orbital Hyperostotic Meningiomas with Proptosis and Visual Impairment: A Therapeutic Challenge. Report of Three Patients and
Review of the Literature
Germany Retrospective NA 3 62 (49–70) 100% I 3 (100%) NA 3 (100%) Vertigo,
diplopia
2 (66%) 1 (33%) 28
21 Mariniello [27],
Acta
Neurochir (Wein),
2013
Surgical Unroofing of the Optic Canal and
Visual Outcome in Basal Meningiomas
Italy Retrospective 1986–2006 60 NA NA NA 60 (100%) NA NA Visual field deficit,
diplopia
NA NA 60
22 Boari [28], British
Journal of Neurosurgery,
2013
Management of Spheno-Orbital en Plaque Meningiomas: Clinical Outcome
in a Consecutive Series of 40
Patients
Italy Retrospective 2000–2010 40 53 (NA) 88% NA 35 (88%) 2 (5%) 18 (45%) Visual field deficit,
diplopia
22 (56%) 18 (44%) 73
23 Saeed [29], Br J Ophthalmol, 2011 Surgical Treatment of Spheno-Orbital Meningiomas Netherlands Retrospective 1980–2006 66 46 (26–68) 92% NA 51 (77%) NA 66 (100%) Diplopia,
headache
39 (59%) 15 (23%) 102
24 Simas [30], Surg Neurol Int,
2013
Sphenoid Wing en Plaque Meningiomas: Surgical Results and Recurrence Rates Portugal Retrospective 1998–2008 18 52 (27–75) 83% I (18) 5 (28%) 1 (6%) 16 (89%) Temporal
region
swelling,
orbital pain,
diplopia,
V1, V2
hypesthesia
7 (39%) 6 (33%) 55
25 Attia [31], World
Neurosurg, 2013
Combined Cranio-Nasal Surgery for Spheno-Orbital Meningiomas Invading the Paranasal Sinuses, Pterygopalatine, and Infra-Temporal Fossa USA Retrospective 2009–2011 3 60 (44–82) 66% I (2), II (1) 2 (67%) 1 (33%) 2 (67%) V palsy 1 (33%) 1 (33%) 10
26 Marcus [32], Acta
Neurochir (Wien),
2013
Image-Guided Resection of Spheno-Orbital Skull-Base Meningiomas with Predominant
Intra-
Osseous Component
UK Retrospective 2004–2012 19 44 (25–64) 89% I (17), II (2) 11 (58%) 6 (32%) 12 (63%) Temporal swelling,
headache,
V paresthesia, focal sensory seizures
11 (58%) 2 (11%) 60
27 Mariniello [33],
Clin Neurol Neurosurg, 2013
Management
of the Optic Canal
Invasion and
Visual Outcome in Spheno-Orbital Meningiomas
Italy Retrospective 1986–2006 60 NA NA NA 36 (60%) 19 (34%) 59 (98%) Optic disc
pallor,
optic disc edema
40 (67%) 5 (8%) NA
28 Forster [34], Neurol Res, 2014 Spheno-Orbital Meningiomas: Surgical Management and
Outcome
Germany Retrospective 2003–2013 18 50 (35–69) 100% I (17), II (1) 7 (39%) NA 15 (83%) Diplopia,
dizziness
13 (72%) NA 44
29 Solmaz [35], Turk
Neurosurg,
2014
Surgical Strategies
for the
Removal of Spheno-Orbital Meningiomas
Turkey Retrospective 2006–2013 13 34 (26–58) 23% I (13) 8 (62%) NA 10 (77%) Facial pain,
orbital pain,
epilepsy
4 (31%) 0 26
30 Talacchi [36],
Neurosurg Rev,
2014
Surgical Management of Ocular Symptoms in Spheno-Orbital Meningiomas. Is Orbital Reconstruction Really Necessary? Italy Retrospective 1992–2012 47 57 (21–77) 56% NA 24 (51%) 18 (32%) 46 (98%) Periorbital
and temporal
swelling
24 (51%) NA 52
31 Berhoum [37],
Neurosurg Focus,
2014
Endoscopic Endonasal Optic Nerve and
Orbital Apex
Decompression for Nontraumatic Optic Neuro-pathy: Surgical Nuances and
Review of the Literature
France Retrospective 2012–2014 4 58 (49–67) 75% NA 4 (100%) NA NA Visual field deficit NA NA 6
32 Amirjamshidi [38], Surg Neurol Int,
2015
Lateral Orbito tomy Approach for
Removing
Hyper -ostosing en Plaque Sphenoid Wing Meningiomas. Description of Surgical Strategy and Analysis of Findings in
a Series of 88
Patients with Long-Term
Follow-up
Iran Retrospective 1979–2013 88 46 (12–70) 74% NA 65 (74%) NA 88 (100%) Visual field deficit,
diplopia
NA 31 (35%) 135
33 Leroy [39], Acta
Neurochir (Wein),
2016
Internal and
External Spheno-Orbital Meningioma Varieties:
Different Outcomes and Prog-noses
France Retrospective 1995–2012 70 52 (21–80) 90% I (60), II (5), III (5) 27 (39%) NA 56 (80%) Soft tissue
tumefaction, headache, retrobulbar pain,
whimpering, seizure,
dizziness,
diplopia
15 (11%) 18 (30%) 57
34 Bowers [40], J Neurosurg, 2016 Outcomes After Surgical Treatment of Meningioma-Associated Prop -
tosis
USA Retrospective 2002–2015 33 52 (12–76) 73% NA 17 (52%) NA 22 (22%) Visual field deficit,
diplopia,
proptosis
31 (94%) 2 (6%) 54
35 Peron [41], Acta
Neurochir Suppl,
2017
Spheno-Orbital Meningiomas: When the Endoscopic Approach is Better Italy Retrospective 2013–2014 30 46 (8–82) 73% NA 1 (3%) 8 (27%) 21 (70%) Visual field deficit,
diplopia,
V1 and V2
hypoesthesia
24 (80%) NA NA
36 Terrier [42], World
Neurosurgery,
2017
Spheno-Orbital Meningiomas Surgery: Multicenter Management Study for Complex
Extensive
Tumors
France Retrospective 1996–2016 130 51 (28–74) 92% I 49 (38%) 13 (10%) 123 (95%) Retro-orbital pain,
diplopia,
headache
97 (75%) 2 (2%) 77
37 Freeman [4], World Neurosurgery,
2017
Spheno-Orbital Meningiomas: A 16-Year
Surgical Experience
USA Retrospective 2000–2016 25 51 (39–71) 92% I (21), II (5) 19 (76%) NA 22 (88%) Diplopia,
headache,
seizure
NA 11 (25%) 45
38 Gonen [43], Neurosurg Rev,
2017
Spheno-Orbital Meningioma: Surgical Series and
Design of an
Intra-
Operative Management Algorithm
Israel Retrospective 2005–2014 27 53 (27–78) 89% NA 10 (37%) 4 (15%) 25 (92%) Visual field deficit,
diplopia,
proptosis,
seizure
14 (52%) 1 (3%) 41
39 Almeida [44],
J Neurosurg, 2018
Trans-Orbital Endoscopic Eyelid Approach for Resection of Spheno-Orbital Meningiomas with Predominant Hyper-ostosis: Report of 2 Cases USA Retrospective NA 2 59 (53–65) 100% I (2) 2 (100%) NA 2 (100%) Visual field deficit 0 (0%) 2 (100%) 2
40 Belinsky [45],
Ophthalmic Plast
Reconstr Surg,
2018
Spheno-Orbital Meningiomas: An Analysis Based on World Health Organization Classification and
Ki-67 Proliferative Index
USA Retrospective 2000–2016 46 56 (27–85) 58% I (30), II (4), III (4) 15 (33%) 4 (9%) 15 (33%) seizure,
altered mental status,
double vision, epiphora,
headache,
V1
hypoesthesia
NA 25 (66%) 63
41 Dallan [46], Oper
Neurosurg (Hagerstown),
2018
Endoscopic Trans-
Orbital Superior Eyelid Approach for the Management of Selected Spheno-Orbital Meningiomas: Preliminary Experience
Italy Retrospective 2012–2015 14 51 (35–73) 86% I (14) 6 (43%) 2 (14%) 14 (100%) Diplopia,
pain,
epiphora
3 (21%) 0 (0%) 25
42 Kong [47],
J Neurosurg, 2018
Clinical and Ophthalmological
Outcome of Endoscopic Trans-Orbital Surgery for
Cranio-
Orbital Tumors
Korea Retrospective 2016–2017 12 56 (38–73) 92% NA 7 (58%) 7 (39%) 14 (78%) NA 4 (33%) NA 5
43 Pace [48], Ophthalmic Plast
Reconstr Surg,
2019
Orbital Reconstruction via
Deformable Titanium Mesh Following Spheno-Orbital Meningioma Resection: Ophthalmic Presentation and Outcomes
USA Retrospective 1996–2017 20 56 (19–89) 80% NA 9 (45%) 3 (15%) 20 (100%) Diplopia,
visual field
deficit
15 (75%) 4 (20%) 47
44 Nagahama [3],
World
Neurosurg,
2019
Spheno-Orbital Meningioma: Surgical Outcomes and Management of Recurrence Japan Retrospective 1996–2017 12 49 (20–71) 58% I (15), II (2) 3 (25%) NA 11 (92%) Trigeminal
hypoesthesia
3 (23%) 1 (8%) 74
45 De Rosa [49],
Acta
Neurochir (Wien),
2019
Endoscopic Endo- and
Extra-
Orbital Corridors for Spheno-Orbital Region: Anatomic Study with
Illustrative Case
Italy Retrospective NA 1 37 100% NA 0 0 1 (100%) Lateral
nystagmus, hypesthesia V1
NA NA 6
46 Shapey [1], Acta
Neurochir (Wien),
2019
A Single Centre’s Experience of Managing Spheno-Orbital Meningiomas: Lessons for Recurrent Tumour Surgery London Retrospective 2005–2016 31 49 (44–58) 65% I (23), II (11) 13 (38%) 6 (18%) 13 (38%) Diplopia,
seizures,
headaches,
trigeminal pain, confusion/
somnolence
29 (85%) 4 (11,8%) 52
47 Young [6], Orbit,
2019
Combined NeuroSurgical and
Orbital Intervention for Spheno-Orbital Meningiomas—the Manchester Experience
UK Retrospective 2000–2017 24 50 (NA) 92% I (23), II (1) 17 (71%) 3 (13%) 21 (88%) Diplopia,
headache,
visual field
deficit
0 (0%) 7 (29%) 82
48 Menon [50], J Neurosci Rural Pract, 2020 Spheno-Orbital Meningiomas: Optimizing
Visual Outcome
India Retrospective 10 years 17 51 (17–72) 76% I (14) e II (3) 14 (82%) NA 14 (82%) Headache,
facial
paresthesia
2 (12%) 15 (88%) 56
49 Goncalves [51],
J Neurol Surg B Skull Base,
2020
Trans-Orbital Endoscopic Surgery for Sphenoid Wing Meningioma: Long-Term Outcomes and
Surgical Technique
South Africa Retrospective 2015–2019 21 48,8 (34–79) 95% I (20), II (1) 21 (100%) 1 (5%) 20 (95%) Headache,
facial pain,
diplopia, blocked nose, epiphora
NA 1 (5%) 12
50 Park [52], World
Neurosurg, 2020
Comparative Analysis of Endoscopic Trans-Orbital Approach and Extended Mini-Pterional Approach for Sphenoid Wing Meningiomas with Osseous Involvement: Preliminary Surgical Results Republic of Korea Retrospective 2015–2019 24 54 (24–73) 67% NA NA NA NA Headache,
cognitive
decline,
diplopia
21 (88%) NA 20
51 Parish [53],
J Neurol Surg Rep, 2020
Proptosis,
Orbital Pain, and Long-Standing Monocular Vision Loss
Resolved by Surgical Resection of Intra-
Osseous Spheno-Orbital Meningioma:
A Case Report and Literature
Review
USA Retrospective 2013 1 43 100% NA 1 (100%) NA 1 (100%) Headache,
periorbital
pain
NA NA 12
52 Samadian, World
Neurosurg, 2020
Surgical Outcomes of Spheno-Orbital en Plaque Meningioma: A 10-Year Experience
in 57 Consecutive
Cases
Iran Retrospective 2007–2017 57 48 (22–76) 93% NA 16 (28%) NA 47 (83%) Visual field deficit,
diplopia
48 (84%) 6 (11%) 46
53 Zamanipoor Najafabadi [54],
Acta
Neurochirurgica (Wein),
2021
Visual Outcomes Endorse Surgery of Patients with Spheno-Orbital Meningioma with Minimal Visual Impairment or Hyperostosis Netherlands Retrospective 2015–2019 19 47 (45–50) 95% I 10 (53%) NA 16 (84%) Diplopia,
headache,
visual field
deficit
14 (76%) 3 (16%) 46
54 In Woo [55], Graefes Arch Clin Exp
Ophthalmol, 2021
Orbital Decompressive effect of Endoscopic Transorbital Surgery for Spheno-Orbital Meningioma South Korea Retrospective 2016–2019 18 54 (38–72) 89% I (16), II (1) 10 (56%) 4 (22%) 17 (94%) Visual field deficit 3 (17%) 12 (67%) 20
55 Masalha [56],
Front Oncol, 2021
Progression-Free Survival, Prognostic Factors, and
Surgical Outcome of Spheno-Orbital Meningioma
Germany Retrospective 2000–2020 65 55 77% I (52), II (13) NA NA NA NA 26 (40%) 15 (23%) 120
56 Dalle Ore [57],
J Neurosurg, 2021
Hyperostosing Sphenoid Wing Meningiomas: Surgical Outcomes and Strategy for Bone Resection and Multidisciplinary
Orbital Reconstruction
USA Retrospective NA 54 52 (30–79) 83% I (45) e II (9) 28 (52%) NA 40 (74%) Visual field deficit,
proptosis,
diplopia
11 (20%) 18 (33%) 31
57 Gomes dos Santos [58], Surg Neurol Int,
2022
Spheno-Orbital Meningiomas: Is Orbit Reconstruction Mandatory? Long-Term Outcomes and
Exophthalmos Improvement
Brazil Retrospective 2008–2018 40 50 (NA) 88% I (39) e II (1) 26 (65%) 8 (20%) 36 (90%) Visual field deficit,
headaches
26 (65%) 10 (25%) 39
58 Locatelli [59],
J Neurol Surg B
Skull Base,
2022
The Role of the Trans-Orbital
Superior Eyelid Approach in the Management of Selected Spheno-Orbital Meningiomas: In-Depth Analysis of Indications, Technique, and Outcomes from the Study of a Cohort of 35
Patients
Italy Retrospective 2011–2021 35 57 (38–80) 77% I (31), II (4) 11 (32%) 7 (20%) 22 (63%) Visual field deficit,
proptosis,
diplopia,
seizure
16 (46%) NA 32
59 Wierzbowska [2],
J Clin Med, 2023
Spheno-Orbital Meningioma and Vision Impairment—Case
Report and
Review of the Literature
Poland Retrospective NA 1 46 100% I Yes No Yes NA 1 (100%) NA 78