Management of Tumors Involving the Cavernous Sinus: Experience of 10 Cases

ABSTRACT

OBJECTIVE: The authors present the complications after resection of the tumors involving the cavernous sinus and the efficacy and role of the adjuvant therapy in the management of the residual or recurrent tumors invading the cavernous sinus. METHODS: From March 1998 to May 2002, ten patients with cavernous sinus tumors were treated in our hospital. The tumors limited to the outer wall of cavernous sinus were excluded in this study. Pathological diagnoses were meningiomas in seven and pituitary adenomas in three patients. RESULTS: Tumors of the extracavernous portion were removed totally except for two cases. Cavernous sinus was opened in seven patients, among which subtotal removal was achieved in four, and partial removal in three patients. In the remaining three patients, the cavernous sinus was neither opened nor exposed. All patients with intracavernous exploration were complicated by ptosis and extraocular muscles paralysis. Radiotherapy was administered to 6 cases. At present, there is no tumor progression except for one patient with malignant meningioma. CONCLUSION: In patients with large tumors involving the cavernous sinus, especially invading the cavernous internal carotid artery, we recommend subtotal or partial resection of the tumor followed by radiation therapy to prevent permanent postoperative sequele.