Surgical Management of Extracranial Meningiomas Arising in the Head and Neck

  • Moustafa Mourad
    Resident Physician, Division of Facial Plastic Surgery, Department of Otolaryngology–Head & Neck Surgery, The New York Eye & Ear Infirmary, New York, NY
    Search for articles by this author
  • David Chan
    Fellow Physician, Department of Otolaryngology Head and Neck Surgery, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, TX
    Search for articles by this author
  • Yadranko Ducic
    Address correspondence and reprint requests to Dr Ducic: Otolaryngology and Facial Plastic Surgery Associates, 923 Pennsylvania Ave, Ste 100, Fort Worth, TX 76104
    Professor, Department of Otolaryngology Head and Neck Surgery, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, TX
    Search for articles by this author
Published:March 23, 2016DOI:


      To determine outcomes in the management of extracranial meningiomas of the head and neck.

      Patients and Methods

      This is a retrospective single-surgeon series performed at a tertiary-care referral center. In all, 23 patients met the inclusion criteria, consisting of 12 men and 11 women. The mean age of patients treated was 60.5 years (range, 32 to 71 years). Subsite involvement included the infratemporal fossa (n = 8), greater wing of the sphenoid and orbit (n = 7), clivus (n = 2), and parapharyngeal space (n = 6).


      In all, recurrence occurred in 21% of patients (n = 5) who underwent gross tumor resection. Two patients underwent subtotal resection because of the tumor's location within the clivus with adjuvant CyberKnife therapy (Accuray, Sunnyvale, CA). Both patients had persistent disease with no new neurologic symptoms. Examination showed that 100% of patients (N = 23) had dural involvement. Post-ablative complications occurred in 43% of patients (n = 10).


      We 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 showed dural involvement. A more unified nomenclature is required for the characterization of these lesions.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic and Personal
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Oral and Maxillofacial Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Friedman C.D.
        • Costantino P.D.
        • Teitelbaum B.
        • et al.
        Primary extracranial meningiomas of the head and neck.
        Laryngoscope. 1990; 100: 41
        • Whicker J.H.
        • Devine K.D.
        • MacCarty C.S.
        Diagnostic and therapeutic problems in extracranial meningiomas.
        Am J Surg. 1973; 126: 452
        • Lang F.F.
        • Macdonald O.K.
        • Fuller G.N.
        • DeMonte F.
        Primary extradural meningiomas: A report on nine cases and review of the literature from the era of computerized tomography scanning.
        J Neurosurg. 2000; 93: 940
        • Hoye S.J.
        • Hoar C.S.
        • Murray J.E.
        Extracranial meningioma presenting as a tumor of the neck.
        Am J Surg. 1960; 100: 486
        • Farr H.W.
        • Gray G.F.
        • Vrana M.
        • Panio M.
        Extracranial meningioma.
        J Surg Oncol. 1973; 5: 411
        • Rosencrantz M.
        • Stattin S.
        Extradural meningiomas. Report of two cases.
        Acta Radiol Diagn (Stockh). 1972; 12: 419
        • Saade R.
        • Hessel A.
        • Ginsberg L.
        • et al.
        Primary extradural meningioma presenting as a neck mass: Case report and review of the literature.
        Head Neck. 2015; 37: E92
        • Rasmussen T.B.
        • Kernohan J.W.
        • Adson A.W.
        Pathologic classification, with surgical consideration, of intraspinal tumors.
        Ann Surg. 1940; 111: 513
        • Hallpike J.F.
        • Stanley P.
        A case of extradural spinal meningioma.
        J Neurol Neurosurg Psychiatr. 1968; 31: 195
        • Lopez D.A.
        • Silvers D.N.
        • Helwig E.B.
        Cutaneous meningiomas—A clinicopathologic study.
        Cancer. 1974; 34: 728
        • Azar-Kia B.
        • Sarwar M.
        • Marc J.A.
        • Schechter M.M.
        Intraosseous meningioma.
        Neuroradiology. 1974; 6: 246
        • Arana E.
        • Diaz C.
        • Latorre F.F.
        • et al.
        Primary intraosseous meningiomas.
        Acta Radiol. 1996; 37: 937
        • Crawford T.S.
        • Kleinschmidt-DeMasters B.K.
        • Lillehei K.O.
        Primary intraosseous meningioma. Case report.
        J Neurosurg. 1995; 83: 912
        • Mattox A.
        • Hughes B.
        • Oleson J.
        • et al.
        Treatment recommendations for primary extradural meningiomas.
        Cancer. 2010; 117: 24
        • Juratli T.A.
        • Geiger K.D.
        • Weigel P.
        • et al.
        A five year-old child with clear cell petro-clival meningioma: Case report with clinical and histopathological long-term follow-up.
        Childs Nerv Syst. 2015; 31: 2193