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. 2023 Mar 20:18:100179.
doi: 10.1016/j.wnsx.2023.100179. eCollection 2023 Apr.

Endoscopic endonasal transsphenoidal surgery for the cavernous sinus hemangioma: Surgical application and review of the literature

Junhao Zhu  1 , Zixiang Cong  1 , Chiyuan Ma  1   2   3   4
Affiliations

Endoscopic endonasal transsphenoidal surgery for the cavernous sinus hemangioma: Surgical application and review of the literature

Junhao Zhu et al. World Neurosurg X. .

Abstract

Aim: Cavernous sinus hemangiomas (CSHs) are hypervascular malformations and the surgical treatment is technically demanding. Although some articles have reported resection of CSHs using endoscopic endonasal transsphenoidal surgery (EETS), most of them were encountered for a lack of preoperative strategy guidance. Herein, we reported gross total resection (GTR) of intrasellar CSHs in two patients undergoing strategical EETS and compared EETS with frontotemporal craniotomy (FC) and stereotactic radiosurgery by literature review.

Material and methods: Two patients with CSHs who underwent EETS were reported. The literature review was conducted to exhaust studies that reported surgical treatment for CSHs. The tumor resection rate, and the postoperative short-term and long-term newly-developed or deteriorative cranial-nerve function rates were extracted.

Results: GTR was achieved with no postoperative complications in the two cases. Nine articles reported 14 cases undergoing EETS for CSHs and twenty-three articles reported 195 cases undergoing FC for CSHs. The GTR rates of EETS and FC were 57.14% (8/14) and 78.97% (154/195) respectively. The postoperative short-term and long-term newly-developed or deteriorative cranial-nerve function rates were 0% (0/7) and 0% (0/6) for the EETS group, and 57% (57/100) and 18.18% (18/99) for the FC group. According to the previous meta-analysis, stereotactic radiosurgery resulted in remarkable tumor shrinkage in 67.80% (40/59) of patients and partial shrinkage in 25.42% of patients.

Discussion: The results showed that the intrasellar type of CSHs could be removed safely by EETS without crossing the nerves in the CS.

Keywords: Cavernous sinus hemangioma; Endoscopic endonasal transsphenoidal surgery; Skull base.

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Conflict of interest statement

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.

Figures

Fig. 1
Fig. 1
The preoperative (A and B) and postoperative (C and D) MR images of Case 1.
Fig. 2
Fig. 2
The preoperative (A and B) and postoperative (C and D) MR images of Case 2.
See this image and copyright information in PMC

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