Spheno-Orbital Meningiomas: Indications and Limitations

Spheno-orbital meningiomas (SOMs) are a unique type of intracranial meningioma where radical resection is often not possible based on its location and biological behavior. Historically treated via traditional transcranial approach, SOMs have recently been managed via a more conservative route. The superior eyelid approach (SEA), or transorbital approach, potentially with lateral orbital rim osteotomy, represents a very versatile procedure able to offer adequate working space when dealing with selected SOMs. Ideal candidates for SEA have not been identified and clear indications are still lacking. In this work we present our personal experience and recommendations regarding how to achieve the best safety and efficacy for this procedure, as well as its proper indications.