Benign nonmeningeal tumors of the cavernous sinus

OBJECTIVE: Resection of benign cavernous sinus tumors with minimum morbidit y and mortality is increasingly more common. Although meningiomas have domi nated most discussions, numerous nonmeningeal tumors also deserve attention because they are generally more amenable to radical surgical resection. METHODS: We reviewed the records of 40 patients (19 female and 21 male pati ents) who were treated surgically during a 15-year period for benign, nonme ningeal tumors of the cavernous sinus. Invasive pituitary adenomas (14 case s) and trigeminal schwannomas (13 cases) comprised the majority of tumors; the remaining tumor types were hemangioma, neurofibroma, juvenile angiofibr oma, dermoid tumor, giant cell tumor, chondromyxofibroma, and chondroma. Pa tient age ranged from 7 to 65 years (mean, 37 yr). RESULTS: All patients underwent surgery, the intent being total resection. Total resection was achieved in 33 (82.5%) of the 40 patients. Follow-up wa s achieved via a combination of direct patient visit or phone interview or via the referring physician. Eight patients had undergone previous surgery elsewhere, which correlated closely with complications and neurophthalmolog ical outcomes but did not affect resectability. Postoperatively, 89.7% of t he patients had either stable or improved extraocular muscle function compa red with their preoperative statuses. Forty percent of the patients experie nced improvement of their preoperative extraocular muscle deficits. Complic ations included cerebrospinal fluid leak (three cases), postoperative hemor rhage (one case), fat embolism (one case), perforator distribution infarct (one case), hydrocephalus requiring ventriculoperitoneal shunting (two case s), transient hemiparesis (one case), and diabetes insipidus (one case). CONCLUSION: We conclude that benign nonmeningeal tumors of the cavernous si nus can be safely and radically removed and result in good long-term neuro- ophthalmological function and low morbidity and mortality. furthermore, whe n compared with our previously reported results for cavernous sinus meningi omas, benign nonmeningeal tumors of the cavernous sinus carry a better chan ce of total removal, a lower incidence of postoperative ocular dysfunction, and a higher rate of recovery of preoperative cranial nerve deficits (7).