title: Meningiomas in the region of the cavernous sinus: a review of 21 patients.
abstract: This is a review of 21 patients with meningiomas involving the region of the cavernous sinus. All underwent surgery, and the fronto-zygomatic (F-Z) approach, first described by Fujitsu and Kubawara, was employed in every case. The mean age at presentation was 47 years; seven patients were male and 14 female. The mean duration of symptoms before surgery was 4 years. In 10 patients, resection was considered to be complete. Peri-operatively there were two deaths, but the majority of deficits in the survivors were temporary and quickly resolved. The mean follow-up period was 48 months. In that time, five patients experienced recurrence or progression of tumour, of whom three required repeat operation (followed by radiotherapy); and two patients were referred for radiotherapy alone. These five patients appear to be disease-free 2-5 years after their additional treatment. Of the 19 patients who left hospital, 17 were able to live independent lives. It would appear from this review that: (1) F-Z craniotomy usually gives excellent exposure to the region of the cavernous sinus; (2) selected patients should undergo angiography with balloon occlusion to evaluate the collateral vascular supply; (3) regular review should include annual MRI. Evaluation over a much longer time of both surgery and radiotherapy, individually and in combination, is needed before it will be possible to furnish a treatment protocol for individual cases at initial presentation or recurrence.
authors.affiliation: Atkinson Morley's Hospital, Wimbledon, London, UK.
authors.forename: D K
authors.initials: DK
authors.lastname: Kim
authors.forename: J
authors.initials: J
authors.lastname: Grieve
authors.forename: D J
authors.initials: DJ
authors.lastname: Archer
authors.forename: D
authors.initials: D
authors.lastname: Uttley
mesh_terms: D000328:Adult; D000368:Aged; D002426:Cavernous Sinus / Q000473:pathology / Q000601:surgery*; D003399:Craniotomy / Q000379:methods; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008579:Meningioma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D015996:Survival Rate