2025 Proffered Presentations
S246: FUNCTIONAL AND COSMETIC RESULTS IN PATIENTS WITH HYPEROSTOTIC SPHENOORBITAL MENINGIOMAS ACCORDING TO THE TECHNIQUE OF SURGICAL DEFECT RECONSTRUCTION.
Nikolay Lasunin; Abdulla Abdullaev; Anna Kadasheva; Kirill Efremov; Burdenko Neurosurgical Center
Introduction: Hyperostotic sphenoorbital meningiomas (HSOM) represent a group of benign tumors that necessitate a multidisciplinary treatment approach. Currently, advanced technologies and treatment algorithms for patients with this condition yield a high overall survival rate of 91% and a recurrence-free survival rate of 44% over ten years. As a result, the quality of life during the postoperative period has become increasingly significant.
Material: To evaluate the quality of life in patients with HSOM, we developed a specialized questionnaire that captures the patient's subjective assessment of their quality of life across several indicators: physical condition, emotional well-being, work and social interactions, vision, appearance, sensitivity, and pain. We conducted a survey involving 216 patients. The average time elapsed from the surgical intervention (or the most recent surgery in the case of multiple operations) to the survey was 30.7 months (approximately 2.5 years). The mean age of the surveyed patients was 57.2 years, with a male-to-female ratio of 1:7 among the participants.
Results: The median total score was 93 points, with a mean score of 92.37 points. Among the surveyed patients, the minimum total score on the questionnaire was 35 points (just 8 points above the minimum possible), while the maximum score was 129 points out of a possible 135. Analysis of the survey results revealed significant differences in quality of life between men and women who underwent surgery for HSOM: women reported a significantly lower quality of life in terms of subjective assessments of vision (p=0.001), sensitivity and pain (p=0.017), and cosmetic outcomes (p=0.027) (Pic. 1). Another factor that showed a strong negative correlation with treatment outcomes in terms of quality of life was the number of neurosurgical interventions undergone. Repeated removal of HSOM significantly decreased quality of life both overall (p<0.001) and in specific categories, except for overall physical functioning, where no significant relationships were found (p=0.18). The most pronounced differences were noted in the categories of "sensitivity and pain" (p=0.001) and "cosmetic result" (p<0.001).
The best results were achieved using 3D modeling and 3D printing technologies, along with single-stage reconstruction not only of the convexital bone defect but also of all resected orbital walls (p=0.013). Furthermore, involvement of certain functionally significant areas in the pathological process was associated with reduced quality of life indicators. For instance, involvement of the superior orbital fissure in the pathological process was a significant predictor of deterioration in quality of life, both in terms of the total score (p=0.007) and in individual categories ("sensitivity and pain" (p=0.001), "visual functions" (p=0.045), and "cosmetic result" (p=0.003)) (Pic. 2).
Conclusions: Patients with HSOM constitute a distinct group, and assessing their quality of life is challenging without a specialized questionnaire. An alternative could involve using several questionnaires to cover individual categories that contribute to overall quality of life. Utilizing a specialized questionnaire and assessing quality of life at all stages of treatment will facilitate a personalized approach and optimize treatment strategies for patients with HSOM.