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[Diagnosis and treatment of cavernous sinus neurinoma]
Zhen Wu1, Jun-ting Zhang, Gui-jun Jia
1Department of Neurosurgery, Tiantan Hospital, Beijing 100050, China.
Objective:
To study the diagnosis and microneurosurgical treatment of cavernous sinus neurinoma.
Methods:
Twenty-two patients with cavernous sinus neurinoma which had been diagnosed by MRI were operated on by microsurgery. Fourteen patients received excision of tumor through frontotemporal approach with zygomatic osteotomy and, 8 patients via subtemporal and suboccipital transtentorial approaches.
Results:
Total resection was achieved in 21 patients (95.5%), and subtotal resection in 1. There was no operative death. The all operative samples were confirmed neurinoma pathologically. The symptoms postoperation such as headache and exophthalmos were reduced. Three months after operation, the function of the 6th nerve was improved in 12 of 19 patients with paresis of the 6th nerve. One patient with hemiplegia recovered well. The function of the 3th nerve recovered in 4 of 6 patients with recurrent paresis of the 3th nerve. Those patients with hydrocephalus were improved after operation. The patients were follow up 8 - 60 months (mean 20 months). No tumor recurrence was observed.
Conclusion:
Cavernous sinus neurinoma can be removed successfully via subtemporal and suboccipital transtentorial approaches.
Insights
Microsurgery successfully removed cavernous sinus neurinomas in 22 patients, with high rates of total resection and symptom improvement. This study highlights effective surgical outcomes for these rare tumors.
Area of Science:
- Neurosurgery
- Oncology
- Neurology
Context:
- Cavernous sinus neurinomas are rare tumors requiring specialized surgical approaches.
- Diagnosis relies heavily on Magnetic Resonance Imaging (MRI).
Purpose:
- To evaluate the efficacy and safety of microneurosurgical treatment for cavernous sinus neurinomas.
- To assess surgical outcomes, including resection rates and functional recovery.
Summary:
- Twenty-two patients with cavernous sinus neurinoma underwent microsurgery.
- High rates of total resection (95.5%) were achieved using frontotemporal and transtentorial approaches.
- Significant improvement in neurological deficits, including cranial nerve palsies and hydrocephalus, was observed post-operatively.
Impact:
- Demonstrates the feasibility and success of microsurgical resection for cavernous sinus neurinomas.
- Provides evidence for improved patient outcomes and quality of life after surgical intervention.
- Contributes to the understanding of surgical management strategies for this challenging condition.