海绵窦脑膜瘤（CSM）是颅底脑膜瘤中最难治疗的亚组之一。本研究的目的是评估针对症状性 CSM 的跨学科治疗方法的疗效，该方法结合了保守的功能保留显微手术和常规辅助分割立体定向放射治疗 (FSRT)。 2005 年期间，对一组患有症状性原发性 CSM 伴海绵体外扩展的同质患者进行了治疗2012 年和 2012 年。所有患者均可接受至少 5 年的随访。临床随访包括详细检查动眼神经缺陷、视力状态和内分泌功能。通过肿瘤体积测定进行放射学随访。总体而言，本研究纳入了 23 名患者（78.3% 为女性；中位年龄 58 岁）。复视是最常见的症状，其次是头痛和视力障碍。手术发病率较低（3/23；13%）。术后平均 2 个月后应用 FSRT。中位临床随访时间为 113 个月，70.45% 的症状有所改善，25% 保持不变，2 例（4.54%）出现恶化。在 103 个月的中位放射学随访中，19/21 世界卫生组织 1 和 1/2 世界卫生组织 2 CSM 中的总体肿瘤消退明显。我们的研究结果证明了跨学科治疗方法对症状性症状的有效性。原发性 CSM 伴海绵体外延伸，神经血管元件减压，然后进行 FSRT。精确的术前计划和术中决策与常规术后放疗相结合，可以实现良好的肿瘤控制，改善神经功能，并最大限度地降低长期发病率。版权所有 © 神经外科医生大会 2024。保留所有权利。

Cavernous sinus meningiomas (CSM) pose one of the most difficult to treat subgroup of skull base meningiomas. The purpose of this study was to evaluate the efficacy of an interdisciplinary treatment approach for symptomatic CSM which incorporated conservative function preserving microsurgery and routine adjuvant fractionated stereotactic radiotherapy (FSRT).A homogenous group of patients with symptomatic primary CSM with extracavernous extension was treated between 2005 and 2012. All patients were available for a minimum follow-up of 5 years. Clinical follow-up included detailed examination of oculomotor deficits, visual status, and endocrinologic function. Radiologic follow-up was conducted by tumor volumetry.Overall, 23 patients were included in this study (78.3% women; median age 58 years). Diplopia was the most common presenting symptom, followed by headache and visual disturbances. Surgical morbidity was low (3/23; 13%). FSRT was applied after a median of 2 months after surgery. At a median clinical follow-up of 113 months, 70.45% of the presenting symptoms had improved, 25% remained unchanged, and in 2 cases (4.54%), worsening occurred. Overall tumor regression was evident in 19/21 World Health Organization 1 and in 1/2 of World Health Organization 2 CSM, respectively, at a median radiological follow-up of 103 months.Our findings demonstrate the efficacy of an interdisciplinary treatment approach for symptomatic primary CSM with extracavernous extension with decompression of neurovascular elements followed by FSRT. Precise preoperative planning and intraoperative decision making in combination with routine postoperative radiotherapy can achieve excellent tumor control, improve neurologic function, and minimize long-term morbidity.Copyright © Congress of Neurological Surgeons 2024. All rights reserved.