Treatment of cavernous sinus (CS) pathologies is still the subject of many discussions. The enthusiasm which was brought into the field of surgical treatment of vascular and tumorous pathologies of the region more than two decades ago has not faded away.
On the contrary, the number of neurosurgeons who devoted enough time to the anatomy of the region are convinced that surgery will remain to be the most important modality of treatment for CS tumorous pathologies also in the future.
The introduction of radiosurgery into the field has not replaced neurosurgical treatment of tumors of
the region; however, this is a very important adjunct treatment modality to surgery. The endovascular treatment of the ICA aneurysms in the CS becomes an important modality and has a great future because it is believed that the balloon(s), coils, and glue should be combined with the stenting of the ICA at the skull base aneurysms. However, even the most sophisticated and advanced endovascular treatment will not be able to rule out surgery, in particular in those fusiform aneurysms in which a long segment of the ICA has to be repaired in order to provide the patency of the ICA. And if endovascular treatment of this kind of lesions will not provide an acceptable solution, and direct neurosurgery will not be in the position to reconstruct the diseased ICA, then either a short high-flow by-pass or another kind of by-passing of the blood flow will be needed, and will only be possible by surgical techniques. The alternative answer in this kind of treatment will be found in a combination of different procedures of different modalities in order to provide this end result.
The advancement in treatment of vascular and tumorous pathologies in the central skull base
during the last two decades has been great in understanding of the normal and pathological anatomy as well as in eradicating the pathologies. In the surgical domain of treatment of tumorous pathologies of the central skull base, the major advancement has been in refining the approaches from above, that is transcranial, as well as from below, that is splanchnocranial.
The initial enthusiasm for each of the transcranial and splanchnocranial approaches has reached already the zenith and is now on the level which does allow co-existence of the other approaches as well. And again, in the future, a combination of the transcranial and splanchnocranial approaches will
be used more frequently for the same pathology. It is evident that when surgery will not be successful in total eradicating the tumorous lesion, radiosurgery – Gamma Knife, Proton Beam treatment, etc. – will be included accordingly.
Vinko V. Dolenc
Contents
Chapter 1. Anatomy of the cavernous sinus
- The middle cranial base and cavernous sinus
- The transition between the cavernous sinus and orbit
- Venous anatomy of the lateral sellar compartment
- Central skull base anatomy as seen through the endoscope
Chapter 2. Surgical approaches to the central skull base
- Evolution from the classical pterional to the contemporary approach to the central skull base
- Extended endoscopic endonasal transsphenoidal approach to supra-parasellar tumors
Chapter 3. Neuromonitoring in central skull base surgery
- Neuromonitoring in central skull base surgery
Chapter 4. Surgical treatment of vascular lesions in the central skull base
- Surgical treatment of large/giant carotid–ophthalmic and other intradural internal carotid artery aneurysms
- Surgical treatment of basilar apex aneurysms – surgical approaches and techniques
- Aneurysms of the intracavernous ICA: current treatment
Chapter 5. Surgical treatment of tumorous lesions in the central skull base
- Cavernous sinus meningiomas
- Surgery of cavernous sinus meningiomas: advantages and disadvantages
- Trigeminal neurinomas: surgical considerations
- Bypasses for cavernous sinus tumors: history, techniques, and current status
- Giant pituitary tumors: surgical treatment of 265 cases
Chapter 6. Radiosurgery in treatment of central skull base tumors
- The role of Gamma Knife surgery in the management of non-meningeal tumors of the cavernous sinus
Subject index
Product Details
- Hardcover: 227 pages
- Publisher: Springer; 1 edition (April 7, 2009)
- Language: English
- ISBN-10: 3211721371
- ISBN-13: 978-3211721377
- Product Dimensions: 10.4 x 7.8 x 0.7 inches
List Price: $279.00