Skip to main content
SpringerLink
Log in

Management of Tumours Involving the Cavernous Sinus

  • Conference paper
Processes of the Cranial Midline

Part of the book series: Acta Neurochirurgica Supplementum ((NEUROCHIRURGICA,volume 53))

Summary

The operative experience with 137 tumours of the cavernous sinus at the University of Pittsburgh during the past 7 years is reported. The importance of the normal and tumour-infiltrated cavernous sinus anatomy and imaging is delineated. 63% of the tumours are benign, primarily meningiomas, for which an anatomical grading system is presented. The various operative approaches to the cavernous sinus are described. 88% of the meningiomas were totally resected. There was a 1.5% operative mortality and 1.5% severe morbidity rate. Initial ipsilateral opthalmoplegia progressively improved in the majority of patients. For all patients with at least 6 months of follow up of benign tumours, the intracavernous tumour recurrence rate was 3% and total recurrence rate was 6%.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Al-Mefty O, Smith RR (1988) Surgery of tumors invading the cavernous sinus. Surg Neurol 30: 370–381

    Article  PubMed  CAS  Google Scholar 

  2. Barnett HJM (1978) Delayed cerebral ischemic episodes distal to occlusion of major cerebral arteries. Neurology 28: 769–774

    PubMed  CAS  Google Scholar 

  3. Brackett CE (1953) The complications of carotid artery ligation in the neck. J Neurosurg 10: 91–106

    Article  PubMed  Google Scholar 

  4. Diaz FG, Ohaegbulam S, Dujovny M, Ausman JI (1988) Surgical management of aneurysms in the cavernous sinus. Acta Neurochir (Wien) 91: 25–28

    Article  CAS  Google Scholar 

  5. Dolenc V (1983) Direct microsurgical repair of intracavernous vascular lesions. J Neurosurg 58: 824–831

    Article  PubMed  CAS  Google Scholar 

  6. Dyste GN, Beck DW (1989) De novo aneurysm formation following carotid ligation: Case report and review of the literature. Neurosurgery 14: 88–92

    Article  Google Scholar 

  7. Erba SM, Horton JA, Latchaw RE, Yonas H, Sekhar LN, Schramm V, Pentheny S (1988) Balloon test occulsion of the internal carotid artery with stable xenon/CT cerebral blood flow imaging. AJNR 9: 533–538

    PubMed  CAS  Google Scholar 

  8. Faria MA, Fleischer AS, Spector RH (1980) Bilateral giant intracavernous carotid aneurysms treated by bilateral carotid ligation. Surg Neurol 14: 207–210

    PubMed  Google Scholar 

  9. German WJ, Black SPW (1965) Cervical ligation for internal carotid aneurysms: An extended follow-up. J Neurosurg 23: 572–577

    Article  PubMed  CAS  Google Scholar 

  10. Hakuba A, Nishimura S, Tskanoto M (1982) Surgical approaches to the cavernous sinus: Report of 19 cases. Neurol Med Chir (Tokyo) 22: 295–308

    Article  CAS  Google Scholar 

  11. Hakuba A, Tanaka K, Suzuki T, Nishimura S (1989) A combined orbitozygomatic infratemporal epidural and subdural approach for lesions involving the entire cavernous sinus. J Neurosurg 71: 699–704

    Article  PubMed  CAS  Google Scholar 

  12. Harris FS, Rhoton AL (1976) Anatomy of the cavernous sinus, a microsurgical study. J Neurosurg 45: 169–180

    Article  PubMed  CAS  Google Scholar 

  13. Hayreh SS, Ramji D (1962) The ophthalmic artery, origin and intracranial and intracanalicular course. Br J Ophthalmol 46: 65–98

    Article  PubMed  CAS  Google Scholar 

  14. Hirsch WL Jr, Hryshko FG, Sekhar LN, Brunberg J (1988) Comparison of MR imaging, CT and angiography in the evaluation of the enlarged cavernous sinus. AJR 151: 1015–1023

    PubMed  Google Scholar 

  15. Inoue T, Rhoton AL, Theele D, Barry ME (1990) Surgical approaches to the cavernous sinus: A microsurgical study. Neurosurgery 26: 903–932

    Article  PubMed  CAS  Google Scholar 

  16. Lesion F, Jonin M (1987) Direct microsurgical approach to intracavernous tumors. Surg Neurol 28: 17–22

    Article  Google Scholar 

  17. Matas R (1914) Testing the efficiency of the collateral circulation as a preliminary to the occlusion of the great surgical arteries. Ann Surg 53: 1–43

    Article  Google Scholar 

  18. Matas R (1914) Testing the efficiency of the collateral circulation as a preliminary to the occlusion of the great surgical arteries. JAMA 63: 1441–1447

    Article  Google Scholar 

  19. Matas R, Allen CW (1911) Occlusion of large surgical arteries with removable metallic bands to test the efficiency of the collateral circulation. JAMA 56: 233–239

    Article  Google Scholar 

  20. Oldershaw JB, Voris HC (1966) Internal carotid artery ligation, follow-up study. Neurology 16: 937–938

    Google Scholar 

  21. Olivecrona H (1944) Ligature of the carotid artery in intracranial aneurysms. Acta Chir Scand 91: 353–368

    Google Scholar 

  22. Parkinson D (1964) Collateral circulation of the cavernous carotid artery: anatomy. Can J Surg 7: 251–268

    PubMed  CAS  Google Scholar 

  23. Parkinson D (1965) Surgical approach to the cavernous portion of the carotid artery: Anatomic studies and case report. J Neurosurg 23: 474–483

    Article  PubMed  CAS  Google Scholar 

  24. Parkinson D (1979) Anatomy of the cavernous sinus. In: Pia HW, Langmaid C, Zierski J (eds) Cerebral aneurysms: advances in diagnosis and therapy. Springer New York, pp 62–66

    Google Scholar 

  25. Parkinson D (1979) Surgical approach to cavernous sinus aneurysms. In: Pia HW, Langmaid C, Zierski J (eds) Cerebral aneurysms: advances in diagnosis and therapy. Springer, New York, pp 224–228

    Google Scholar 

  26. Parkinson D, West M (1990) Lesions of the cavernous plexus region. In: Youmans JR (ed) Neurological surgery. W. B. Saunders, Philadelphia, pp 3351–3370

    Google Scholar 

  27. Perneczky A, Knosp E, Vorkapic P, Czech TH (1985) Direct surgical approach to infraclinoid aneurysms. Acta Neurochir (Wien) 76: 36–44

    Article  CAS  Google Scholar 

  28. Rhoton AL Jr, Hardy DG, Chambers SM (1979) Microsurgical anatomy and dissection of the sphenoid bone, cavernous sinus and sellar region. Surg Neurol 12: 63–104

    PubMed  Google Scholar 

  29. Sekhar LN, Burgess J, Atkin O (1987) Anatomical study of the cavernous sinus emphasizing operative approaches and related vascular and neural reconstruction. Neurosurgery 21: 806–816. (Also presented at the International Symposium on Cavernous Sinus, Ljubljana, Yugoslavia, 1986 )

    Article  PubMed  CAS  Google Scholar 

  30. Sekhar LN, Linskey ME, Sen CN, Altschuler EM (1990) Surgical management of lesions within the cavernous sinus. In: Black Peter McL (ed) Clinical neurosurgery 37. Williams and Wilkins, Baltimore, MD, pp 440–489

    Google Scholar 

  31. Sekhar LN, Moller AR (1986) Operative management of tumors involving the cavernous sinus. J Neurosurg 64: 879–889

    Article  PubMed  CAS  Google Scholar 

  32. Sekhar LN, Pomeranz S, Sen CN (in press) Cavernous sinus lesions. In: Brock M (ed) Modern neurosurgery

    Google Scholar 

  33. Sekhar LN, Schramm VL Jr, Jones NF (1986) Operative exposure and management of the petrous and upper cervical carotid artery. Neurosurgery 19: 967–982

    Article  PubMed  CAS  Google Scholar 

  34. Sekhar LN, Sen CN, Jho HD, Janecka IP (1988) Surgical treatment of intracavernous neoplasms: A four-year experience. Neurosurgery 24: 18–30

    Article  Google Scholar 

  35. Sekhar LN, Sen CN, Jho HD (1990) Saphenous vein graft bypass of the cavernous internal carotid artery. J Neurosurg 72: 35–41

    Article  PubMed  CAS  Google Scholar 

  36. Spetzler RF, Fukushima T, Martin N, Zabramski JM (1990) Petrous carotid-to-intradural carotid saphenous vein graft for intracavernous giant aneurysm, tumor and occlusive cerebrovascular disease. J Neurosurg 73: 496–502

    Article  PubMed  CAS  Google Scholar 

  37. Taptas JN: The so-called cavernous sinus (1982) A review of the controversy and its implications for neurosurgeons. Neurosurgery 11: 712–717

    Article  PubMed  CAS  Google Scholar 

  38. Umansky F, Nathan H (1982) The lateral wall of the cavernous sinus, with special reference to the nerves related to it. J Neurosurg 56: 228–234

    Article  PubMed  CAS  Google Scholar 

  39. Willinksy R, Lasjaunias P, Berenstein A (1987) Intracavernous branches of the internal carotid artery (ICA): Comprehensive review of their variations. Surg Radiol Anat 9: 201–215

    Article  Google Scholar 

  40. Winn HR, Richardson AE, Jane JA (1977) Late morbidity and mortality of common carotid ligation for posterior communicating aneurysms. A comparison of conservative treatment. J Neurosurg 47: 727–736

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

    L. N. Sekhar M.D., F.A.C.S., Sh. Pomeranz & Ch. N. Sen

Authors
  1. L. N. Sekhar M.D., F.A.C.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sh. Pomeranz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ch. N. Sen
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, University of Vienna Medical School, Vienna, Austria

    Wolfgang Koos  & Bernd Richling  & 

Rights and permissions

Reprints and permissions

Copyright information

© 1991 Springer-Verlag

About this paper

Cite this paper

Sekhar, L.N., Pomeranz, S., Sen, C.N. (1991). Management of Tumours Involving the Cavernous Sinus. In: Koos, W., Richling, B. (eds) Processes of the Cranial Midline. Acta Neurochirurgica Supplementum, vol 53. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9183-5_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-9183-5_18

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-9185-9

  • Online ISBN: 978-3-7091-9183-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation