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Improving Function in Cavernous Sinus Meningiomas: A Modern Treatment Algorithm

Background: The efficacy and safety of radiosurgery led to paradigm shift in the management of cavernous sinus meningiomas. Nevertheless, patients are still significantly affected by cranial nerve deficits related to the mass effect of these tumors. Our management strategy involves the combination o...

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Autores principales: Beer-Furlan, André, Priddy, Blake H., Jamshidi, Ali O., Shaikhouni, Ammar, Prevedello, Luciano M., Ditzel Filho, Leo, Otto, Bradley A., Carrau, Ricardo L., Prevedello, Daniel M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7393208/
https://www.ncbi.nlm.nih.gov/pubmed/32793095
http://dx.doi.org/10.3389/fneur.2020.00652
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author Beer-Furlan, André
Priddy, Blake H.
Jamshidi, Ali O.
Shaikhouni, Ammar
Prevedello, Luciano M.
Ditzel Filho, Leo
Otto, Bradley A.
Carrau, Ricardo L.
Prevedello, Daniel M.
author_facet Beer-Furlan, André
Priddy, Blake H.
Jamshidi, Ali O.
Shaikhouni, Ammar
Prevedello, Luciano M.
Ditzel Filho, Leo
Otto, Bradley A.
Carrau, Ricardo L.
Prevedello, Daniel M.
author_sort Beer-Furlan, André
collection PubMed
description Background: The efficacy and safety of radiosurgery led to paradigm shift in the management of cavernous sinus meningiomas. Nevertheless, patients are still significantly affected by cranial nerve deficits related to the mass effect of these tumors. Our management strategy involves the combination of a functional surgical decompression followed by radiation therapy. Methods: We reviewed a single institution's cohort of patients who underwent endoscopic endonasal decompression (EED) for symptomatic meningiomas primarily involving the cavernous sinus (CS) from 2010 to 2016. The preoperative neuro-ophthalmological exam was compared to the 1- and 6-month postoperative exams. The patient's length of hospital stay, complications, and radiological and clinical follow-up were noted. Results: A total of 17 patients underwent EED for CS meningiomas that fit our radiological criteria. The final outcome at the 6-month visit showed five patients (62.5%) with normalization of deficit and three patients (37.5%) with partial improvement of the CNII deficit. Out of the 12 patients who had cavernous sinus cranial nerves (CSCN) deficits, the final outcome at the 6-month visit showed four patients (33.33%) with normalization of deficit, seven patients (58.3%) with partial improvement, and one patient (8.33%) with no improvement. There were no intraoperative complications. Conclusion: The EED for CS meningiomas is a valuable technique when addressing acute/subacute CNII and CSCN deficits. This conservative surgical approach showed good functional outcomes, low morbidity, and low complication rates. However, it does not exempt the need for radiosurgery/radiation therapy for control of tumor growth.
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spelling pubmed-73932082020-08-12 Improving Function in Cavernous Sinus Meningiomas: A Modern Treatment Algorithm Beer-Furlan, André Priddy, Blake H. Jamshidi, Ali O. Shaikhouni, Ammar Prevedello, Luciano M. Ditzel Filho, Leo Otto, Bradley A. Carrau, Ricardo L. Prevedello, Daniel M. Front Neurol Neurology Background: The efficacy and safety of radiosurgery led to paradigm shift in the management of cavernous sinus meningiomas. Nevertheless, patients are still significantly affected by cranial nerve deficits related to the mass effect of these tumors. Our management strategy involves the combination of a functional surgical decompression followed by radiation therapy. Methods: We reviewed a single institution's cohort of patients who underwent endoscopic endonasal decompression (EED) for symptomatic meningiomas primarily involving the cavernous sinus (CS) from 2010 to 2016. The preoperative neuro-ophthalmological exam was compared to the 1- and 6-month postoperative exams. The patient's length of hospital stay, complications, and radiological and clinical follow-up were noted. Results: A total of 17 patients underwent EED for CS meningiomas that fit our radiological criteria. The final outcome at the 6-month visit showed five patients (62.5%) with normalization of deficit and three patients (37.5%) with partial improvement of the CNII deficit. Out of the 12 patients who had cavernous sinus cranial nerves (CSCN) deficits, the final outcome at the 6-month visit showed four patients (33.33%) with normalization of deficit, seven patients (58.3%) with partial improvement, and one patient (8.33%) with no improvement. There were no intraoperative complications. Conclusion: The EED for CS meningiomas is a valuable technique when addressing acute/subacute CNII and CSCN deficits. This conservative surgical approach showed good functional outcomes, low morbidity, and low complication rates. However, it does not exempt the need for radiosurgery/radiation therapy for control of tumor growth. Frontiers Media S.A. 2020-07-24 /pmc/articles/PMC7393208/ /pubmed/32793095 http://dx.doi.org/10.3389/fneur.2020.00652 Text en Copyright © 2020 Beer-Furlan, Priddy, Jamshidi, Shaikhouni, Prevedello, Ditzel Filho, Otto, Carrau and Prevedello. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Beer-Furlan, André
Priddy, Blake H.
Jamshidi, Ali O.
Shaikhouni, Ammar
Prevedello, Luciano M.
Ditzel Filho, Leo
Otto, Bradley A.
Carrau, Ricardo L.
Prevedello, Daniel M.
Improving Function in Cavernous Sinus Meningiomas: A Modern Treatment Algorithm
title Improving Function in Cavernous Sinus Meningiomas: A Modern Treatment Algorithm
title_full Improving Function in Cavernous Sinus Meningiomas: A Modern Treatment Algorithm
title_fullStr Improving Function in Cavernous Sinus Meningiomas: A Modern Treatment Algorithm
title_full_unstemmed Improving Function in Cavernous Sinus Meningiomas: A Modern Treatment Algorithm
title_short Improving Function in Cavernous Sinus Meningiomas: A Modern Treatment Algorithm
title_sort improving function in cavernous sinus meningiomas: a modern treatment algorithm
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7393208/
https://www.ncbi.nlm.nih.gov/pubmed/32793095
http://dx.doi.org/10.3389/fneur.2020.00652
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