de Carvalho Rodolfo Figueiredo, de Morais Artur Nóbrega Lima, Olijnyk Leonardo Desessards, Abrao Adriana Azeredo Coutinho, Zanatta Claudia, da Silva Carlos Eduardo
Department of Neurosurgery and Skull Base Surgery, Hospital Ernesto Dornelles, Porto Alegre/RS, Brazil.
Department of Anatomy, DCBS, Federal University of Health Sciences of Porto Alegre- UFCSPA, Porto Alegre/RS, Brazil.
J Neurol Surg B Skull Base. 2021 Apr 8;83(Suppl 3):e611-e612. doi: 10.1055/s-0041-1725942. eCollection 2022 Aug.
We present a case of a 37-year-old female, with progressive left eye proptosis and an extensive ipsilateral en plaque spheno-orbital meningioma, with diffuse involvement of the lateral wall of the cavernous sinus and the orbit. A cranio-orbital zygomatic approach was performed to reach all extension of the lesion. We made an extradural clinoidectomy and an extensive bone removal of the orbit, exposition of the superior and lateral walls of the cavernous sinus, unroofing of the optic canal, superior orbital fissure, foramen rotundum, and foramen ovale. We performed the peeling of the lateral wall of cavernous sinus with total removal and preservation of the cranial nerves anatomy and function. In this video, we illustrate the importance of the first time aggressive removal of such tumors. We also demonstrate the concept that secondary invasion of the cavernous sinus are suitable for removal with cranial nerve preservation. The link to the video can be found at https://youtu.be/GJmkqVa6jSs .
我们报告一例37岁女性病例，患有进行性左眼突出及广泛的同侧蝶眶脑膜瘤板层状病变，海绵窦外侧壁及眼眶均有弥漫性受累。采用颅眶颧入路以暴露病变的所有范围。我们进行了硬膜外床突切除术及广泛的眼眶骨质切除，暴露海绵窦的上壁和外侧壁，打开视神经管、眶上裂、圆孔和卵圆孔。我们对海绵窦外侧壁进行了剥离，完整切除肿瘤并保留颅神经的解剖结构和功能。在本视频中，我们阐述了首次积极切除此类肿瘤的重要性。我们还展示了海绵窦继发性侵犯适合在保留颅神经的情况下进行切除这一概念。视频链接可在https://youtu.be/GJmkqVa6jSs 找到。
