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Cranial Bones: Lateral View

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The lateral view of the cranium is dominated by temporal, sphenoid, and ethmoid bones.
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Updated: Nov 19, 2025

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery

Published on: July 5, 2021

Cavernous Sinus Meningioma Resection Through Orbitozygomatic Craniotomy.

Edinson Najera¹, Baha'eddin A Muhsen¹, Hamid Borghei-Razavi¹

¹Department of Neurosurgery, Cleveland Clinic Florida Egil and Pauline Braathen Center, Neurological Institute, Cleveland Clinic, Weston, Florida, USA.

World Neurosurgery

|January 30, 2021

Summary

This summary is machine-generated.

Surgical resection of cavernous sinus meningiomas is feasible and can improve cranial nerve deficits. Complete tumor removal is achievable with detailed knowledge of surgical anatomy, offering a low-morbidity treatment option.

Keywords:

Cavernous sinus Cavernous sinus meningioma Orbitozygomatic approach

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Area of Science:

Neurosurgery
Neuro-oncology
Skull Base Surgery

Background:

Cavernous sinus meningiomas pose significant neurosurgical challenges due to complex anatomy and potential for neurovascular injury.
Traditional management options include observation, stereotactic radiosurgery, and surgical resection, with varying degrees of success and controversy.
Patients often present with cranial nerve deficits (III-VI), proptosis, and visual disturbances.

Observation:

A 43-year-old male presented with recurrent trigeminal nerve (V3 distribution) numbness, ptosis, and diplopia due to a progressing cavernous sinus meningioma.
Initial treatment with stereotactic radiosurgery provided temporary relief.
Neurological examination revealed trigeminal sensory deficits and a cranial nerve VI palsy.

Findings:

Gross total resection of the clear cell grade 2 meningioma was achieved via an orbitozygomatic craniotomy, working laterally within the cavernous sinus.
Postoperative improvement in facial numbness, eyelid ptosis, and extraocular movements was observed.
Histopathology confirmed a grade 2 meningioma, followed by adjuvant radiosurgery.

Implications:

Surgical resection of cavernous sinus meningiomas is a feasible and effective treatment with low morbidity.
Detailed understanding of cavernous sinus surgical anatomy and approaches is crucial for safe and complete tumor removal.
Successful resection can lead to significant improvement in pre-existing cranial nerve dysfunction.