Endonasal Endoscopic Management of Parasellar and Cavernous Sinus Meningiomas

Neurosurg Clin N Am. 2015 Jul;26(3):389-401. doi: 10.1016/j.nec.2015.03.004. Epub 2015 May 7.

Abstract

The management of cavernous sinus and invasive parasellar meningiomas often requires a multimodality treatment approach. Early attempts at complete or near-complete removal of parasellar meningiomas involving the cavernous sinus, Meckel cave, clivus, and sella using anterolateral or lateral skull base approaches were typically unsuccessful and yielded high rates of new cranial neuropathy and other complications. This article presents a strategy of endonasal endoscopic parasellar skull base bony decompression and limited tumor removal followed by stereotactic radiotherapy, stereotactic radiosurgery, or observation. Patient selection, technical nuances, potential complications, and initial outcomes in a small series of patients are discussed.

Keywords: Cavernous sinus meningioma; Endonasal endoscopic approach; Minimally invasive neurosurgery; Parasellar meningioma.

Publication types

  • Review

MeSH terms

  • Cavernous Sinus / surgery*
  • Decompression, Surgical / methods
  • Humans
  • Meningeal Neoplasms / surgery*
  • Meningioma / surgery*
  • Natural Orifice Endoscopic Surgery / methods
  • Neuroendoscopy / methods*
  • Nose
  • Patient Selection
  • Radiosurgery / methods*
  • Sella Turcica / surgery*