Complete Resection of the Cavernous Sinus-Indications and Technique

Complete cavernous sinus resection is an option for patients with progressive or recurrent tumors after standard therapy. Extended survival can occur in some patients. The risks of surgery are considerable, and the underlying disease, age of the patient, and associated comorbidities should be considered when making the decision to operate. Surgery should be considered for oncologic resection of malignant tumors with limited extracranial disease or in patients with recurrent or progressive benign tumors. A key decision involves whether revascularization should be used with resection. Revascularization has been used in patients with inadequate vascular reserve as measured by balloon occlusion testing and patients with benign tumors and longer life expectancy.