The Analysis Of Clinical Diagnosis And Treatment Of Cavernous Sinus Cavernous Hemangioma

Background: Cavernous hemangioma is a rare benign tumorin cavernous sinus region and higher incidence of middle-agedfemale patients The onset of Cavernous hemangioma is hiddenand slow，The majority of cases are founded in the brain parenchyma，Cerebral cavernous hemangioma are rare，which Accounts for about0.4%~2.0%of all intracranial cavernous hemangioma，Belong to a special type of cavernous hemangioma。Cerebral cavernous hemangioma often Located in the Sella region andThe bottom of the middle skull fossa。It is called epidural cavernous hemangioma because of its relatively relationship with epidural。The primary treatment of Cavernous hemangioma is Surgical removal。Owing to the preoperative diagnosis of Cavernous sinus hemangioma is difficult，deep position， restricted of exposure，it is full of challenge. Due to the nerves and vascular tissue structure surrounding the cavernous sinus area is complex, bleeding occurrs very frequently.Having a good command of the microdissection position of cavernous sinus region,which can reduce intraoperative bleeding and cranial nerve injury. The surgical approach of this disease should formulate reasonable and specific,which can effectively reduce the appearance of complications and improve patient quality of life.Objective:To evaluate the advantage of Clinicaldiagnosis,imaging characteristics,microscopic surgery and radiation therapy of cavernous sinus hemangiomas, Analyse the surgicaltreatment methods and treatment status.According to the patientssituation and set up the best surgical approach.Methods: Collected17cases of patients with cavernous sinus hemangiomas from Jan2003to Jan2013in hospital, retrospective analysis were made with these cases in Clinical information and imaging examination, Reviewed the relevant literature, and summing up of the clinical diagnosis and microsurgical methods and curative effect of this disease.Results:11cases of female,6cases of male; clinical Course with2months to6years,17patients aged from36to69,Patients suffered with symptoms of headache, Vision loss, Limited extraocular muscle function. Imaging shows that the tumor islocated in cavernous sinus region,9cases locate on the leftside cavernous sinus area and8cases of the right side Tumordiameter is from3.8cm to7.0cm;Imaging examination: hypodensity on T1WI and hyperdensity on T2WI sequence on MRI,Enhanced scanning with contrast and have a Clear boundary.14cases underwent total remove,And confirmed by pathology were cavernous hemangioma, Among the19cases,3cases underwent only surgical exploration accounted for17.6%of the totalnumber of cases, due to the inadequate experience in the earlyof20thcentrury. After operation6cases with oculomotor nervepalsy,4cases acget recovery from3to6months.10patientswith postoperative follow-up. Eight months to9years (average45months),Six patients had different degrees of oculomotor nerveparalysis restored, All the patients can live on their own, No tumor recurrence.Conclusion: subdural approach is divided into sphenoide approach, zygomatic sphenoide approach and frontal orbital zygomatic approach. Applicable to wide and limitations type.Epidural approachas zygomatic frontalpterion approach.Apply for limited type.Limitation of pterion approach is suitable for small volume type lesions,Diameter <3cm,In the removal of small size of the cavernoussinus cavernous hemangioma,Adopting this approach can effectively reveal and resection of the tumor.The advantage is small leision,and short operation time. Zygomatic arch pterion approach can fully exposed in the structure and cavernous sinus.Suitable for large cavernous hemangioma of the cavernous sinus, Surgicalresection is the first choice treatment of cavernous hemangioma of the cavernous sinus.So according to the patient health condition to set up the reasonable surgical approaches is the key factor to the operation.Because of the cavernous sinus cavernous hemangiomahas a hiding history, mostly when the tumors were found often have larger size, So the MRI scan is the main diagnostic methods of cavernous sinus cavernous hemangioma, plays an important role in diagnosis of cavernous hemangioma. Often mistaken with Cavernous sinus trigeminal schwannoma and the pituitarytumor. Clear CSHAS preoperative diagnosis is very important.Combined with clinical manifestations and imaging examination, thecomprehensive analysis,To make a diagnosis and perform treatment, making optimal operation plan.