Authors: Jorge Agi, Ezekiel Weis, Jaime Badilla, Alim P. Mitha, David Steinke

Author Disclosure Block: J. Agi: None. E. Weis: None. J. Badilla: None. A.P. Mitha: None. D. Steinke: None.

Abstract Body:

Purpose: To describe a standardized orbital resection technique and outcomes for orbital involving sphenoid wing meningiomas.
Study Design: Retrospective study
Methods: A retrospective chart review of 21 patients with sphenoid wing meningiomas with orbital invasion treated surgically between 2008 and 2017, via a modified orbitozygomatic approach using the Alberta Standardized Orbital Technique (ASOT), was performed.
Results: Fifty percent of cases had prior attempted resection prior to referral to our service. Complete resection of the meningioma was achieved in 42.8%, with no recurrences. In cases where the tumor was non-resectable, orbital debulking was performed (57.2% of cases). Among all the debulked patients, 75% had stable disease (with 25% requiring adjuvant external beam radiotherapy). Progressive disease was observed in 25% of the debulked cases. In general, stable orbital disease was obtained in 85.7% of all cases. Standardized follow-up examinations were accomplished in 15 patients. Of these, complications reported were extra-ocular movements restriction (3 cases/20%), visual acuity reduction (2 cases/13.3%), diplopia (2 cases/13.3%), edema (2 case/13.3%), wound infection (1 case/6,6%) and superior sulcus defect (1 case/6.6%)
Conclusions: The ASOT demonstrated to be secure with minimal morbidity. All patients with the pre-operative goal of complete excision had successful complete excision with no recurrence. 75% of patients with symptomatic unresectable tumors presented stable disease after debulking. Overall 85.7% demonstrated stability post-treatment. Complete resection of the tumor in the first surgery