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13.
Cavernous sinus tumors
Dolenc, Vinko V. ...
The authors report their experience with 139 patients with a tumor located in the cavernous sinus (CS). In the period from 1980 trrough 1987 these patients were treated by the snior author, using the ...ditect metrsutgval apptoach. A surgical approach to the CS described previousl4,5 was used in all cases. No special measutes such as extracorporeal circulation with cardiac arrest, hypotherma, lumbar dranage, and ot dehydration, were taken during surgery. Theobjective of the surgety was to accomplish complete resection of tumorous lesion as well as to preserve the internal carotid artery (ICA) pateney and the normal function of the nerves III through VI. Complete tumor excision was possible only in 95 cases whereas in 44 cases partial resection was carried out. Complete resection was impossible because the ICA wall infiltrated by thetumor (20 cases), the nerves III through VI in the lateral wall of the CS were involved in the scar following previous surgery (19 cases), and the surrounding structures had been invaded by the tumor (five cases). Histology revealed benign meningioma in 97 out of a total of 139 tumors. Five patients died after surgery: two from pulmonary complications, one from myocardial infarction, one from massive air embolism, and one from ICA rupture on the 6thpostoperative day. Forty-two patients in whom complete excision of the intracavernous tumor was performed, showed no neurological deficit in the postoperative period. Seventy-two patients had transient paresis of the nerve(s) III through VI which cleared out in the period between 3 weeks and 6 months after surgery whereas in 21 patients nerve palsy persisted. In two patients the optic nerve was injured with the drill on the opening of the optic canal. In other two patients the artery was damaged by resection of the tumor from the ICA.(trunc.)
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