Management of Cavernous Sinus Involvement in Sinonasal and Ventral Skull Base Malignancies

Otolaryngol Clin North Am. 2017 Apr;50(2):365-383. doi: 10.1016/j.otc.2016.12.011.

Abstract

Cavernous sinus (CS) involvement by sinonasal and ventral skull base malignancies is infrequently encountered in neurosurgical practice. Despite advancements in skull base microneurosurgery and endoscopic techniques, detailed knowledge and experience of the surgical management of these lesions are limited. This article elaborates on surgical strategies and approaches for CS involvement of malignant ventral skull base tumors. The article discusses the indications, techniques, nuances, advantages, limitations, and complications of minimally invasive CS biopsy, transcranial microscopic, and transfacial endoscopic approaches to the CS using illustrative diagrams and operative videos. The principles and nuances of a high-flow cerebral revascularization procedure are mentioned.

Keywords: Cavernous sinus; Cerebral revascularization; Sinonasal and ventral skull base malignancy; Skull base tumor; Surgical approach; Technical nuances.

Publication types

  • Review
  • Video-Audio Media

MeSH terms

  • Cavernous Sinus / pathology*
  • Cavernous Sinus / surgery*
  • Cerebral Revascularization
  • Endoscopy
  • Humans
  • Minimally Invasive Surgical Procedures
  • Neurosurgical Procedures
  • Nose Neoplasms / surgery*
  • Postoperative Complications / surgery
  • Skull Base / surgery*
  • Skull Base Neoplasms / surgery*