未经证实:海绵窦脑膜瘤(CSM)的演变可能是不可预测的,并且由于其缓慢的演变,其治疗效果具有挑战性。症状的变化和波动,分类的异质性和缺乏随机对照试验。这里,一个专门的工作组就CSM的整体管理提供了共识声明。
UNASSIGNED:为了确定CSM的最佳整体管理,根据他们的临床表现,尺寸,和进化以及患者特征。
未经批准:使用PRISMA2020指南,我们纳入了2000年1月至2020年12月的文献。总共保留了400份摘要和77份标题,用于全文筛选。
UNASSIGNED:工作组提出了8项建议(C级证据)。CSM应由高度专业化的多学科团队管理。对患者的初步评估包括临床,眼科,内分泌学和放射学评估。CSM的治疗应包括经验丰富的颅底神经外科医生或神经放射科医生,放射肿瘤学家,放射科医生,眼科医生,和内分泌学家。
UNASSIGNED:放射外科是首选的一线治疗方法,随函附上,有症状的病变/老年患者,而不适合切除或WHOII-III级的大型CSM是放疗的候选人。显微外科手术是表现为动眼/视觉/内分泌障碍的年轻患者的侵袭性/快速进展性病变的一种选择。每当手术时,开颅入路是目前的标准。关于内镜经鼻入路治疗CSM的经验报道有限,主要适应症是海绵窦减压以改善症状。每当需要手术时,目前的趋势是提供减压,然后进行放射外科。
UNASSIGNED: The evolution of cavernous sinus meningiomas (CSMs) might be unpredictable and the efficacy of their treatments is challenging due to their indolent evolution, variations and fluctuations of symptoms, heterogeneity of classifications and lack of randomized controlled trials. Here, a dedicated task force provides a
consensus statement on the overall management of CSMs.
UNASSIGNED: To determine the best overall management of CSMs, depending on their clinical presentation, size, and evolution as well as patient characteristics.
UNASSIGNED: Using the PRISMA 2020
guidelines, we included literature from January 2000 to December 2020. A total of 400 abstracts and 77 titles were kept for full-paper screening.
UNASSIGNED: The task force formulated 8 recommendations (Level C evidence). CSMs should be managed by a highly specialized multidisciplinary team. The initial evaluation of patients includes clinical, ophthalmological, endocrinological and radiological assessment. Treatment of CSM should involve experienced skull-base neurosurgeons or neuro-radiosurgeons, radiation oncologists, radiologists, ophthalmologists, and endocrinologists.
UNASSIGNED: Radiosurgery is preferred as first-line treatment in small, enclosed, pauci-symptomatic lesions/in elderly patients, while large CSMs not amenable to resection or WHO grade II-III are candidates for radiotherapy. Microsurgery is an option in aggressive/rapidly progressing lesions in young patients presenting with oculomotor/visual/endocrinological impairment. Whenever surgery is offered, open cranial approaches are the current standard. There is limited experience reported about endoscopic endonasal approach for CSMs and the main indication is decompression of the cavernous sinus to improve symptoms. Whenever surgery is indicated, the current trend is to offer decompression followed by radiosurgery.