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Surgical Management of Extracranial Meningiomas Arising in the Head and Neck

  • Moustafa Mourad
    Affiliations
    Resident Physician, Division of Facial Plastic Surgery, Department of Otolaryngology–Head & Neck Surgery, The New York Eye & Ear Infirmary, New York, NY
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  • David Chan
    Affiliations
    Fellow Physician, Department of Otolaryngology Head and Neck Surgery, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, TX
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  • Yadranko Ducic
    Correspondence
    Address correspondence and reprint requests to Dr Ducic: Otolaryngology and Facial Plastic Surgery Associates, 923 Pennsylvania Ave, Ste 100, Fort Worth, TX 76104
    Affiliations
    Professor, Department of Otolaryngology Head and Neck Surgery, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, TX
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Published:March 23, 2016DOI:https://doi.org/10.1016/j.joms.2016.03.016

      Purpose

      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).

      Results

      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).

      Conclusions

      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.
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