Role of radiosurgery in the management of cavernous sinus meningiomas

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Abstract
Objective ‐ To provide our early experience and philosophy in the utility of radiosurgery in the management of cavernous sinus meningiomas. Methods ‐ Twenty‐five consecutive cases with cavernous sinus meningiomas treated between 1990 and 1995 were reviewed. Three cases were treated with gamma‐knife radiosurgery, 15 with preceding surgery and gamma knife, 7 with surgery. Mean follow‐up following radiosurgery and surgery were 34.8 and 25.4 months, respectively. Results ‐ The 5‐year actuarial tumor control rate following radiosurgery was 85.7% and tumor remission rate was 61.4%. Permanent neurological deterioration after radiosurgery was seen in 1 case (5.9%), whereas newly developed or worsened neurological deficits permanently persisted in 59.1% of patients after surgery. There was a clear correlation between surgical radicality and postoperative morbidity rate. Conclusions ‐ Gamma‐knife radiosurgery is a valuable addition to surgical removal in the treatment of cavernous sinus meningiomas. Combination of non‐radical resection and subsequent radiosurgery is recommended to improve treatment‐associated morbidity.