Pediatric Intracavernous Sinus Lesions: A Single Institutional Surgical Case Series

Background Pediatric intracavernous sinus tumors are exceedingly rare and thus poorly characterized. Their neurosurgical management is challenging, and diagnostic and management guidelines are limited. Here, we report our institutional experience with the surgical resection of pediatric intracavernous sinus tumors. We also compare and contrast our results with 14 cases of pediatric intracavernous sinus lesions in the current literature.

Methods A retrospective descriptive analysis of consecutive pediatric patients (age 0–18 years) presenting to our institution with a diagnosis of an intracavernous sinus lesion was performed. From January 2012 to January 2017, five cases were identified.

Results Surgical resection via a frontotemporal orbitozygomatic (OZM) approach was performed in all cases by a single senior neurosurgeon (M.L.). There were no perioperative or postoperative complications attributable to the surgery or approach. Four of five patients remained neurologically stable throughout the perioperative and postoperative period. The fifth patient had a complete resolution of their cranial neuropathies postoperatively. A pathologic diagnosis that guided long-term management was obtained in all cases.

Conclusion Neurosurgical management of pediatric cavernous sinus lesions can be safely performed and critically guide future therapies. Surgeon familiarity with cavernous sinus and skull base anatomy is critical to the successful management of these patients.