Management of cavernous sinus meningiomas: Consensus statement on behalf of the EANS skull base section.
Cavernous sinus
Consensus statement
Cranial nerves
Gammaknife
Gross total resection
Intracranial meningiomas
Meningioma
Microsurgery
Neurosurgery
Pituitary
Radiosurgery
Radiotherapy
Journal
Brain & spine
ISSN: 2772-5294
Titre abrégé: Brain Spine
Pays: Netherlands
ID NLM: 9918470888906676
Informations de publication
Date de publication:
2022
2022
Historique:
received:
22
11
2021
revised:
08
01
2022
accepted:
16
01
2022
entrez:
17
10
2022
pubmed:
18
10
2022
medline:
18
10
2022
Statut:
epublish
Résumé
The evolution of cavernous sinus meningiomas (CSMs) might be unpredictable and the efficacy of their treatments is challenging due to their indolent evolution, variations and fluctuations of symptoms, heterogeneity of classifications and lack of randomized controlled trials. Here, a dedicated task force provides a consensus statement on the overall management of CSMs. To determine the best overall management of CSMs, depending on their clinical presentation, size, and evolution as well as patient characteristics. Using the PRISMA 2020 guidelines, we included literature from January 2000 to December 2020. A total of 400 abstracts and 77 titles were kept for full-paper screening. The task force formulated 8 recommendations (Level C evidence). CSMs should be managed by a highly specialized multidisciplinary team. The initial evaluation of patients includes clinical, ophthalmological, endocrinological and radiological assessment. Treatment of CSM should involve experienced skull-base neurosurgeons or neuro-radiosurgeons, radiation oncologists, radiologists, ophthalmologists, and endocrinologists. Radiosurgery is preferred as first-line treatment in small, enclosed, pauci-symptomatic lesions/in elderly patients, while large CSMs not amenable to resection or WHO grade II-III are candidates for radiotherapy. Microsurgery is an option in aggressive/rapidly progressing lesions in young patients presenting with oculomotor/visual/endocrinological impairment. Whenever surgery is offered, open cranial approaches are the current standard. There is limited experience reported about endoscopic endonasal approach for CSMs and the main indication is decompression of the cavernous sinus to improve symptoms. Whenever surgery is indicated, the current trend is to offer decompression followed by radiosurgery.
Identifiants
pubmed: 36248124
doi: 10.1016/j.bas.2022.100864
pii: S2772-5294(22)00005-4
pmc: PMC9560706
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100864Informations de copyright
© 2022 The Authors.
Déclaration de conflit d'intérêts
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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