Management of cavernous sinus meningiomas: Consensus statement on behalf of the EANS skull base section: Consensus statement on behalf of the EANS skull base section

Marco V Corniola, Pierre-Hugues Roche, Michaël Bruneau, Luigi M Cavallo, Roy T Daniel, Mahmoud Messerer, Sebastien Froelich, Paul A Gardner, Fred Gentili, Takeshi Kawase, Dimitrios Paraskevopoulos, Jean Régis, Henry W S Schroeder, Theodore H Schwartz, Marc Sindou, Jan F Cornelius, Marcos Tatagiba, Torstein R Meling

Onderzoeksoutput: Articlepeer review

20 Citaten (Scopus)

Samenvatting

INTRODUCTION: 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.

RESEARCH QUESTION: To determine the best overall management of CSMs, depending on their clinical presentation, size, and evolution as well as patient characteristics.

MATERIAL AND METHODS: 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.

RESULTS: 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.

DISCUSSION AND CONCLUSION: 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.

Originele taal-2English
Artikelnummer100864
Pagina's (van-tot)1-16
Aantal pagina's16
TijdschriftBrain and spine
Volume2
DOI's
StatusPublished - 21 jan 2022

Bibliografische nota

Publisher Copyright:
© 2022 The Authors

Copyright:
Copyright 2023 Elsevier B.V., All rights reserved.

Keywords

  • Neurosurgery Cavernous sinus Meningioma Microsurgery Gross total resection Cranial nerves Radiosurgery Radiotherapy Pituitary Consensus statement Intracranial meningiomas Gammaknife

Citeer dit