Zhonghua yi xue za zhi · 2010
[Efficacy of surgical treatment for cavernous sinus hemangiomas].
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Lu Zheng, Zhao Ji-Zong
Аннотация
OBJECTIVE: to analyze the efficacy of surgical treatment for cavernous sinus hemangiomas (CSH).
METHODS: the data from 29 surgical CSH patients, 7 males and 22 females, aged 52 ± 9 years old, at our department were collected from 2003 to 2009 and analyzed retrospectively. The main presenting symptoms included headache (n = 15), impaired visual acuity (n = 9), diplopia (n = 7), ptosis (n = 2), facial paresthesia (n = 6), hemiparesis (n = 1) and infrequent menstruation (n = 4). MRI was major preoperative modality. All patients underwent craniotomy via frontotemporal approach with or without orbitozygomatic osteotomy. The tumor was removed through intradural approach in all patients.
RESULTS: total removal was achieved in 14 (48.3%) patients. And 13 (44.8%) and 2 (6.9%) patients had subtotal and partial procedures respectively. No postoperative death occurred. Follow-up study of 3 months to 6 years was conducted in 27 patients (93%). All headaches were relieved postoperatively. The central nervous symptoms improved in 12 patients. The neuroendocrine symptom had no improvement. The most common surgical complications included impaired visual acuity (n = 2, 6.9%), paralyses of oculomotor nerve (n = 17, 58.6%), abduct nerve (n = 8, 27.6%) and trigeminal nerve (n = 4, 13.8%). A MRI follow-up of 1 - 6 years was obtained in 16 patients without recurrence.
CONCLUSION: surgery is an effective management strategy for CSH. However, total tumor removal remains difficult. Complications such as cranial nerve injury are still rather troublesome.
METHODS: the data from 29 surgical CSH patients, 7 males and 22 females, aged 52 ± 9 years old, at our department were collected from 2003 to 2009 and analyzed retrospectively. The main presenting symptoms included headache (n = 15), impaired visual acuity (n = 9), diplopia (n = 7), ptosis (n = 2), facial paresthesia (n = 6), hemiparesis (n = 1) and infrequent menstruation (n = 4). MRI was major preoperative modality. All patients underwent craniotomy via frontotemporal approach with or without orbitozygomatic osteotomy. The tumor was removed through intradural approach in all patients.
RESULTS: total removal was achieved in 14 (48.3%) patients. And 13 (44.8%) and 2 (6.9%) patients had subtotal and partial procedures respectively. No postoperative death occurred. Follow-up study of 3 months to 6 years was conducted in 27 patients (93%). All headaches were relieved postoperatively. The central nervous symptoms improved in 12 patients. The neuroendocrine symptom had no improvement. The most common surgical complications included impaired visual acuity (n = 2, 6.9%), paralyses of oculomotor nerve (n = 17, 58.6%), abduct nerve (n = 8, 27.6%) and trigeminal nerve (n = 4, 13.8%). A MRI follow-up of 1 - 6 years was obtained in 16 patients without recurrence.
CONCLUSION: surgery is an effective management strategy for CSH. However, total tumor removal remains difficult. Complications such as cranial nerve injury are still rather troublesome.