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  • Title: Direct and remote outcome after treatment of tumours involving the cavernous sinus and its surroundings.
    Author: Ladziński P, Majchrzak H, Maliszewski M, Majchrzak K, Kaspera W, Tymowski M, Adamczyk P.
    Journal: Neurol Neurochir Pol; 2008; 42(5):402-15. PubMed ID: 19105109.
    Abstract:
    BACKGROUND AND PURPOSE: The aim of this study was to present results obtained by the authors after surgical treatment of tumours involving the cavernous sinus (CS) and its surroundings. MATERIAL AND METHODS: Thirty-eight patients (23 females and 15 males) with tumours of the CS and its surroundings were included in the study. The neurological condition of patients and their ability to perform activities of daily living were evaluated prior to treatment, postoperatively and after completion of therapy. The following parameters were measured: approximate volume of the operated lesions; their relation to larger vessels, cranial nerves and the brainstem; consistency and vascularization. RESULTS: The medical history of the disease ranged from 1.5 to 48 months, mean 12 months. In 89.5% of cases impaired ocular motility on the side of the lesion was the symptom indicative of the condition. The second most common group of symptoms (29%) included impairments of trigeminal nerve function. The approximate volume of all resected tumours ranged from 0.6 to 60 mL (mean 12.2 mL). In 50% of cases the resected tumours were diagnosed as meningiomas. The remaining entities included: perithelioma, hypophyseal adenoma, adenoid cystic carcinoma, neuroendocrine carcinoma, trigeminal neurinoma, chordoma, cavernous angioma and lymphoma. In 63% resections were complete. Functional capacity of patients improved in 34% of cases, remained unchanged in 53%, deteriorated in 10.5%, and one patient died. CONCLUSIONS: Surgical intervention involving the CS and its surroundings enables resection of neoplastic tumours of this anatomical region with satisfactory clinical results and low mortality. Most patients suffer from temporary paresis or paralysis of the oculomotor, trochlear and abducent nerves. Reduction of completeness of resections of CS tumours decreases the number of postoperative neurological deficits without a significant increase in the rate of lesion regrowth.
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