Analysis Of Factors Affecting Resection Of Cavernous Sinus Tumors

ObjectiveBy retrospectively analyzing the cases of cavernous sinus tumors undergoing microsurgical resection in our hospital to summarize the classification,grade,imaging features and clinical manifestations of cavernous sinus tumors,so as to provide a preliminary judgment on whether the tumors could be completely excised.At the same time,the relationship between the choice of surgical approach and the location of the tumor was analyzed to provide a basis for the selection of surgical approach for the resection of tumors in the cavernous sinus region.MethodsClinical data of 72 patients with cavernous sinus tumors treated by microsurgery in the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2020 were collected.The pathological properties of tumors,grade of tumors,clinical manifestations,and microsurgical approach were tested by Fisher’s exact test to determine whether there was a correlation between them and the resection of tumors.After that,Fisher’s exact test was used to determine the relationship between each tumor group and tumor grades:The relationship between the choice of surgical approach and tumor location were tested by Fisher’s exact test.ResultsThe results of Fisher’s exact test showed that the tumor resection was correlated with the pathological properties(P<0.01)and the grade(P<0.01).Clinical manifestations and surgical approach were not associated with resection(P>0.01).Statistical analysis of the meningioma group,the schwannoma group,the cavernous hemangioma group and the epidermoid cyst group using Fisher’s exact test showed that the rate of total resection was different among the four groups(P<0.05).The calibration test level was α=0.008 after using the Bonferroni method.Then the Fisher’s exact test was used to compare two to four groups of tumors,the statistical results showed that the rate of total resection between the meningioma group and the schwannoma group,the cavernous hemangioma group,the epidermoid cyst group was statistically significant(P<0.008),while the rate of total resection between the schwannoma group,the cavernous hemangioma group and the epidermoid cyst group was not statistically significant(P>0.008).The Fisher’s exact test for cavernous sinus tumors grade Ⅰ to Ⅲ showed that the rate of total resection among the grades was different(P<0.05).Then using the Bonferroni method to correct the inspection level(a=0.017).Fisher’s exact test was used for the three tumor grades to compare the the rate of total resection,and the results suggested that grade Ⅰ and grade Ⅲ,gradeⅡ and grade Ⅲ have statistical difference(P<0.017),while there was no statistical difference between grade Ⅰ and grade Ⅱ(P>0.017).The statistical results of Fisher’s exact test showed that the choice of surgical approach was related to tumor location(P<0.05).Conclusion1.The rate of total resection for cavernous sinus tumors is related to the pathological properties and the grade of tumors.The data of this study showed that the rate of total resection for meningioma was the lowest,followed by schwannoma,cavernous hemangioma and epidermoid cyst.The rate of total resection for cavernous sinus tumor grade of Ⅰ and Ⅱ is higher than grade Ⅲ.2.The choice of surgical approach is related to the location of the tumor.The pterional approach is suitable for tumors in front of the cavernous sinus,the frontal orbitozygomatic approach is suitable for tumors in front of the cavernous sinus,especially tumors invading into the orbit,the subtemporal anterior petrolitic approach is suitable for the resection of tumors in the posterior cavernous sinus,and the modified pterional approach can complete the resection of tumors with invasion in both the anterior and posterior cavernous sinus.