Analysis Of Risk Factors Affecting The Degree Of Resection Of Cavernous Sinus Meningioma

Background:Meningioma of cavernous sinus is a common tumor in cavernous sinus region,most of which are intracranial benign tumors.With the development of microneurosur-gery,the surgical treatment of cavernous sinus meningioma has been effective.However,due to the complex anatomy at this location,the tumor is difficult to be radically resected,and postoperative tumor recurrence and cranial nerve function defect will affect the patients’ quality of life.Therefore,the correlation between various risk factors and prognosis is still the central point of current research.Methods:We retrospectively reviewed the clinical data of 40 patients with cavernous sinus meningioma treated in the Second Affiliated Hospital of Nanchang University from 2018 to 2022.Statistical software such as SPSS26.0 was used for statistical analysis,to explore the risk factors affecting the degree of tumor resection,and to record the tumor control rate and postoperative cranial nerve function.Results:In this study,25 patients(62.5%)underwent total tumor resection and 15 patients(37.5%)underwent subtotal tumor resection.Univariate analysis showed that preoperative cranial nerve function involvement,maximum tumor diameter,tumor volume,tumor location,and relationship with internal carotid artery were related to the degree of tumor resection,and the differences were statistically significant(P<0.05).The results of multi-factor logistics analysis showed that the relationship between tumor and internal carotid artery and tumor volume were independent risk factors affecting the scope of tumor resection.Postoperative follow-up results:Tumor recurrence or progression occurred in 5 patients,and the tumor control rate was 87.5%.The postoperative cranial nerve improvement rate was 50%(9/18),16 cases of new cranial nerve defects,mainly oculomotor nerve paralysis,a total of 11 cases,7 cases(63.6%)of the patients improved and recovered after six months of follow-up.There was no significant correlation between the degree of tumor resection and the improvement of cranial nerve function.At the last follow-up,the mean KPS was 87.0±10.9(range 40-100),higher than the preoperative mean of 84.0±8.1(range 70100),and the overall quality of life was improved.Conclusion:It is difficult to complete radical resection by microsurgery for patients with cavernous sinus meningioma with large volume and extensive internal carotid artery encirclement.However,surgical treatment has good tumor control rate and obvious decompression effect.Therefore,the treatment principle of cavernous sinus meningioma is as follows:on the basis of preserving and improving cranial nerve function,maximum and safe tumor resection should be carried out.After surgery,stereotactic radiotherapy should be applied to patients who failed to complete resection,which is helpful to improve patients’ quality of life.