Meningiomas Involving the Cavernous Sinus

Abstract

Surgery of the cavernous sinus has received great impetus in the past few years [3, 9], and its indica tions are still being defined [9]. Dolenc et al. [3] have reported 63 patients who underwent neoplastic intracavernous surgery, 40 of whom for meningiomas, with an overall mortality rate of 6%, permanent cranial nerve (II-VI) morbidity of 22%, and a total tumor removal of 71% and 73% of the patients returning to their premorbid activity. Sekhar et al. [9] were able totally to remove 13 of 17 (76%) intracavernous meningiomas, and in 42 patients undergoing intracavernous operations for neoplasms there was no mortality; extraocular muscle function was worse in 12%, better in 42%, and unchanged in 69%, and most of the patients had a good performance score postoperatively. Kawase et al. [5] reported on total removal of 5/7 intracavernous meningiomas, with two patients experiencing permanent cranial nerve worsening. The majority of meningiomas reported by Dolenc et al. [3], Sekhar et al. [9] and Kawase et al. [5] were invading the cavernous sinus from surrounding areas. Lesoin et al. [7], reporting on 16 patients with purely intracavernous meningiomas stated that total removal of intracavernous meningiomas is not possible without permanently jeopardizing cranial nerve function. It is evident that removal of intracavernous meningiomas is more dangerous than removal of intracavernous neurinomas or chondromas [7, 9].