Transcavernous Resection of a Giant Extensive Chondrosarcoma with Endoscopic Assistance

Walid Elshamy; Burcak Soylemez; Sima Sayyahmelli; Nese Keser; Mustafa K. Baskaya

doi:10.1055/s-0041-1727124

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2022; 83(S 03): e644-e645
DOI: 10.1055/s-0041-1727124

Skull Base: Operative Videos

Transcavernous Resection of a Giant Extensive Chondrosarcoma with Endoscopic Assistance

Authors

Walid Elshamy

¹Department of Neurological Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States

²Department of Neurological Surgery, Ain Shams University, Faculty of Medicine, Cairo, Egypt
Burcak Soylemez

¹Department of Neurological Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
Sima Sayyahmelli

¹Department of Neurological Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
Nese Keser

¹Department of Neurological Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
Mustafa K. Baskaya

¹Department of Neurological Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States

Abstract

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Keywords

chondrosarcoma - endoscopic-assisted microsurgery - cavernous sinus - skull base - transcavernous approach

Fig. 1 (A) Preoperative coronal T1-weighted MRI with contrast shows heterogeneously enhancing lesion in the cavernous sinus extending to the posterior fossa, sphenoid sinus infratemporal fossa. (B) Postoperative T1-weighted MRI with contrast shows gross total resection of the lesion from the middle fossa, infratemporal fossa and cavernous sinus. MRI, magnetic resonance imaging.

Fig. 2 Cadaveric and intraoperative photomicrographs. (A) Cadaveric dissection of the cavernous sinus and the middle cranial fossa showing middle meningeal artery (MMA), V1, V2 branches of the trigeminal nerve, and greater superficial petrosal nerve (GSPN). (B) Intraoperative image shows the cisternal segment of the trigeminal nerve after sectioning of the posterior fossa dura and tentorium and removal of the tumor. (C) Intraoperative image shows the cavernous sinus tumor splaying the branches of the trigeminal nerve including V1, V2, and V3. (D) A cadaveric dissection of the cavernous sinus showing the branches of the trigeminal nerve (V1, V2, V3), Gasserian ganglion (GG), trochlear nerve (IV), oculomotor nerve (III), and cavernous internal carotid artery (ICA) after drilling of the overlying bone, middle meningeal artery (MMA), the superior petrosal sinus (SPS), and the greater superficial petrosal nerve (GSPN).

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Figures

Fig. 1 (A) Preoperative coronal T1-weighted MRI with contrast shows heterogeneously enhancing lesion in the cavernous sinus extending to the posterior fossa, sphenoid sinus infratemporal fossa. (B) Postoperative T1-weighted MRI with contrast shows gross total resection of the lesion from the middle fossa, infratemporal fossa and cavernous sinus. MRI, magnetic resonance imaging.

Fig. 2 Cadaveric and intraoperative photomicrographs. (A) Cadaveric dissection of the cavernous sinus and the middle cranial fossa showing middle meningeal artery (MMA), V1, V2 branches of the trigeminal nerve, and greater superficial petrosal nerve (GSPN). (B) Intraoperative image shows the cisternal segment of the trigeminal nerve after sectioning of the posterior fossa dura and tentorium and removal of the tumor. (C) Intraoperative image shows the cavernous sinus tumor splaying the branches of the trigeminal nerve including V1, V2, and V3. (D) A cadaveric dissection of the cavernous sinus showing the branches of the trigeminal nerve (V1, V2, V3), Gasserian ganglion (GG), trochlear nerve (IV), oculomotor nerve (III), and cavernous internal carotid artery (ICA) after drilling of the overlying bone, middle meningeal artery (MMA), the superior petrosal sinus (SPS), and the greater superficial petrosal nerve (GSPN).