title: Endonasal Endoscopic Management of Parasellar and Cavernous Sinus Meningiomas.
abstract: The management of cavernous sinus and invasive parasellar meningiomas often requires a multimodality treatment approach. Early attempts at complete or near-complete removal of parasellar meningiomas involving the cavernous sinus, Meckel cave, clivus, and sella using anterolateral or lateral skull base approaches were typically unsuccessful and yielded high rates of new cranial neuropathy and other complications. This article presents a strategy of endonasal endoscopic parasellar skull base bony decompression and limited tumor removal followed by stereotactic radiotherapy, stereotactic radiosurgery, or observation. Patient selection, technical nuances, potential complications, and initial outcomes in a small series of patients are discussed.
authors.affiliation: The Brain Tumor Center & Pituitary Disorders Program, Providence's Saint John's Health Center, John Wayne Cancer Institute, 2200 Santa Monica Boulevard, Santa Monica, CA 90404, USA.
authors.forename: Bjorn
authors.initials: B
authors.lastname: Lobo
authors.affiliation: The Brain Tumor Center & Pituitary Disorders Program, Providence's Saint John's Health Center, John Wayne Cancer Institute, 2200 Santa Monica Boulevard, Santa Monica, CA 90404, USA.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: The Brain Tumor Center & Pituitary Disorders Program, Providence's Saint John's Health Center, John Wayne Cancer Institute, 2200 Santa Monica Boulevard, Santa Monica, CA 90404, USA.
authors.forename: Garni
authors.initials: G
authors.lastname: Barkhoudarian
authors.affiliation: The Brain Tumor Center & Pituitary Disorders Program, Providence's Saint John's Health Center, John Wayne Cancer Institute, 2200 Santa Monica Boulevard, Santa Monica, CA 90404, USA; Department of Otolaryngology, Pacific Eye & Ear Specialists, 11645 Wilshire Boulevard, Los Angeles, CA 90025, USA.
authors.forename: Chester F
authors.initials: CF
authors.lastname: Griffiths
authors.affiliation: The Brain Tumor Center & Pituitary Disorders Program, Providence's Saint John's Health Center, John Wayne Cancer Institute, 2200 Santa Monica Boulevard, Santa Monica, CA 90404, USA. Electronic address: kellyd@jwci.org.
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Kelly
mesh_terms: D002426:Cavernous Sinus / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods; D006801:Humans; D008577:Meningeal Neoplasms / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods; D044583:Neuroendoscopy / Q000379:methods*; D009666:Nose; D018579:Patient Selection; D016634:Radiosurgery / Q000379:methods*; D012658:Sella Turcica / Q000601:surgery*
keywords: Cavernous sinus meningioma; Endonasal endoscopic approach; Minimally invasive neurosurgery; Parasellar meningioma