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Cavernous sinus meningiomas: retrospective analysis and proposal of a treatment algorithm
Angelo Pichierri1, Antonio Santoro, Antonino Raco
1Department of Neurosciences-Neurosurgery, University of Rome La Sapienza, Rome, Italy. angelopichierri@gmail.com
Neurosurgery
|June 3, 2009
Summary
Surgical treatment for cavernous sinus meningiomas presents challenges. While open sinus surgery showed higher initial morbidity, long-term outcomes and recurrence rates were similar to closed sinus surgery, with radiation therapy aiding stability.
Area of Science:
- Neurosurgery
- Oncology
Background:
- Cavernous sinus meningiomas pose significant surgical challenges.
- Advances in cranial base surgery enable resection, but high complication rates persist.
Purpose of the Study:
- To compare outcomes of open versus closed sinus surgery for cavernous sinus meningiomas.
- To evaluate the efficacy of multimodal treatment including radiation therapy.
Main Methods:
- Retrospective analysis of 147 patients undergoing surgery between 1985-2003.
- Patients divided into open (Group A) and closed (Group B) sinus surgery groups.
- Mean follow-up of 9.7 years.
Main Results:
- Significant differences in early and permanent postoperative morbidity between surgical groups.
- No statistical difference in long-term recurrence or progression rates.
- Postoperative radiation therapy (81.5%) correlated with clinicoradiological stability.
Conclusions:
- Growth control and neurological preservation are key goals for cavernous sinus meningiomas.
- Surgery and radiosurgery alone often insufficient; unresolved issues remain.
- A treatment algorithm is proposed to guide optimal therapeutic choices.
