Evaluation Of Microsurgical Removal Of Cavernous Sinus Tumors

Objective:To retrospectively analyze the cases of microsurgical treatment of cavernous sinus tumors,and to explore the factors affecting the long-term quality of life and the degree of tumor resection,so as to explore individual surgical treatment and improve the therapeutic effect of cavernous sinus tumors.Materials and methods:The clinical data and follow-up data of 59 patients with cavernous sinus tumors treated by neurosurgery in Xiangya second Hospital of Central South University from March 2010 to March 2019 were analyzed retrospectively.The patient data database was established by IBMSPSS22.0 statistical software.1、The Karnofsky Performance Scale quality of life score(KPS score)before and after operation was analyzed by paired T test,the postoperative complications and death were summarized,and the effect of operation was analyzed.2、The last KPS scores of patients with different surgical approaches,tumor types,tumor size and resection degree were compared and analyzed by Fisher precise test,and the factors affecting the long-term quality of life of the patients after operation were analyzed.3 、 The relationship between different surgical approaches,tumor types,tumor size and the degree of resection was compared and analyzed by Fisher precise test,and the factors affecting the degree of surgical resection were analyzed.Results:1、There were 59 patients in this study.The preoperative KPS score was 60～100(mean 77.3±9.5),and the average KPS score within one month after operation was 73.6±11.9.The average KPS score at the last follow-up was 79.5±12.0.The KPS score before operation,the KPS score within 1 month after operation and the KPS score at the last follow-up were tested by pairwise t-test.there was a significant difference between the KPS score at the last follow-up and the KPS score before operation(t=-2.740,p=0.008),and between the KPS score within 1 month after operation(t=-4.627,p=0.000).The difference was statistically significant(P < 0.05).In this group,18 patients had new or aggravated neurological impairment,and 7 patients had other complications.All of them were discharged after conservative treatment.There was no perioperative death in this group.2、In this study,we used the KPS score at the last follow-up as an index to evaluate the long-term quality of life of patients after operation,and discussed the effects of surgical approach(4 kinds),pathological nature of tumor(9 kinds),tumor size(4 types),total resection of tumor and other factors on patients’ long-term quality of life.Statistical analysis by Fisher accurate test showed that there was only significant difference in tumor size between groups(p=0.001).There was no significant difference in other factors such as surgical approach(p=0.818),tumor nature(p=0.407)and total resection(p=0.762).3、In this study,Fisher precise test was used to analyze the effects of surgical approach(4 kinds),tumor pathological nature(9 kinds)and tumor size(4 types)on the total resection rate of tumors.The difference of total resection rate among different tumor types was statistically significant(p=0.029<0.05),the difference of tumor size in total resection rate was statistically significant(p=0.003<0.05),there was no significant difference in total resection rate among different surgical approaches(p=0.245).Conclusion:1.Microsurgery for cavernous sinus tumor has better curative effect and less complications;2.The long-term quality of life of patients with cavernous sinus tumor after microsurgery is related to tumor size;3.The total resection rate of tumor in cavernous sinus is related to tumor type and tumor size.