Meningioma resection – OZO (orbitozygomatic osteotomy)

The case concerns a tumour - meningioma attached to the lateral wall of the left cavernous sinus. The patient was a woman aged 55, admitted to the neurosurgical ward because of a vehicle accident. After the admittance, a CT scan was performed by chance presented the meningioma obscured at first glimpse of the aforementioned sinus, by right temporal pole edema. The patient claimed blurred vision and vision disturbances concerned with extremely left lateral gaze disability. Additionaly, a MRI was performed to depict more peculiarities of the surrounding tissue. Round meningioma found frontal to the temporal pole was apparent.

The operation was done as follows: the left fronto-orbital osteotomy has been divided in two parts. First, the fronto-temporal and, second, orbito-zygomatic osteotomy was conducted. According to the author it is far easier to divide the procedure in two parts than to take in one piece of the bone. In case of putrification, only a part of the bone can be discharged.

The tumour was extracted totally without any lesion neither to the left cavernous sinus nor to the surrounding brain tissue. The attachment to the sinus was coagulated. The wound was closed and the patient was discharged on the sixth day after a CT control scan was made. There was no signs of the tumor remnants. The vision of the patient recovered totally.

Op. neurosurgeon Przemysław Kloczkowski.