Fenestrated Oculomotor Nerve Caused by Meningioma around the cavernous Sinus: A Surgical Pitfall in Tumor Removal: Case Report

Abstract

In this article, Tsutsumi et al. describe a “fenestrated oculomotor nerve” in a case of basal meningioma that led to permanent damage to the nerve. The oculomotor nerve divides into two branches, either in the lateral wall of the cavernous sinus or inside the orbital apex. The upper branch supplies the superior rectus and the levator palpebrae superioris, and the inferior branch supplies the medial rectus and the inferior oblique. The “fenestration” of the oculomotor nerve may represent early branching. If so, the authors must have divided the upper portion of the nerve, judging from the postoperative recovery of only medial rectus function. When the oculomotor nerve is known to be cut at surgery, it is worthwhile to reconstruct the nerve with a short-segment nerve graft, as we have done in three patients (1). The patients do not achieve recovery of binocular function but usually achieve a good...