Raheja Amol, Couldwell William T
Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, United States.
Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, United States.
Handb Clin Neurol. 2020;170:69-85. doi: 10.1016/B978-0-12-822198-3.00029-X.
Cavernous sinus meningioma (CSM) presents a management challenge to present-day neurosurgeons. Lack of adequate understanding of the natural history of these lesions, the early involvement of vital neurovascular structures, the absence of clear tissue planes with normal surrounding structures, and a high rate of aggressive surgery-related morbidity each pose management dilemmas for neurosurgeons. Over the past few decades, the enthusiasm of the neurosurgical community has shifted from aggressive microsurgical resection to maximal safe resection and institution of adjuvant radiotherapy, if necessary. This paradigm shift has ensured better functional outcome in treated patients. This chapter has been designed to discuss the current treatment algorithm and the importance of multimodality management for optimal outcome in patients with CSM. The technical aspects of this approach to management are presented, and the various treatment options are compared.
海绵窦脑膜瘤（CSM）给当代神经外科医生带来了管理挑战。对这些病变自然史的充分了解不足、重要神经血管结构的早期受累、与正常周围结构缺乏清晰的组织平面以及与侵袭性手术相关的高发病率，这些都给神经外科医生带来了管理困境。在过去几十年里，神经外科界的热情已从积极的显微手术切除转向最大安全切除，并在必要时采用辅助放疗。这种模式转变确保了治疗患者有更好的功能预后。本章旨在讨论当前的治疗算法以及多模式管理对CSM患者获得最佳预后的重要性。介绍了这种管理方法的技术方面，并比较了各种治疗选择。
