Introduction Cavernous sinus meningiomas (CSMs) are challenging given their proximity to neurovascular structures. Treatments include surgery, radiation, or observation. There are little data comparing outcomes based on treatment. This study presents the radiographic and functional outcomes of patients with CSMs treated with either radiation, surgical resection ± radiation, or radiographic surveillance.

Methods This is a retrospective review of adults diagnosed with CSMs between 2009 and 2016. Patient and tumor characteristics and outcomes were obtained from chart review. Categorical and continuous variables were compared via nonparametric tests.

Results Sixty-four patients were diagnosed with CSMs between 2009 and 2016. Thirty-four had radiation. Thirteen had surgical resection with adjuvant radiation and 14 underwent observation.

Fifty-four patients had a pretreatment deficit (84.4%). Radiographic control rates were 100% in the surgery group, 97.1% in the radiation group, 69.2% in the surgery + adjuvant radiation, and 90.9% in the observation group (p = 0.035). The radiotherapy group had complete improvement of symptoms in 32.4% and partial improvement in 23.1% (p = 0.022). In the surgery group, one patient had complete resolution of symptoms (6.3%), eight had partial improvement (50.0%), and seven patients had no improvement (p = 0.002). Surgery was more likely to lead to progression of symptoms posttreatment (odds ratio: 5.16, confidence interval: 1.309–20.34) (p = 0.019).

Conclusions Radiation has an excellent rate of radiographic control. Surgery is an option for large or symptomatic lesions. The role of surgery is primarily for vision preservation, decompression of cranial nerves, and tumor debulking and patients should be counseled extensively regarding treatment goals and expectations prior to surgery.

简介 海绵窦脑膜瘤（CSM）由于靠近神经血管结构而具有挑战性。治疗方法包括手术、放射或观察。几乎没有数据比较基于治疗的结果。本研究介绍了接受放射、手术切除±放射或放射学监测治疗的 CSM 患者的放射学和功能结果。

方法 这是对 2009 年至 2016 年间诊断患有 CSM 的成人的回顾性评价。患者和肿瘤的特征和结果是从图表回顾中获得的。通过非参数检验比较分类变量和连续变量。

结果 2009 年至 2016 年间，有 64 名患者被诊断患有 CSM。其中 34 名患者接受过放射治疗。13 例接受手术切除并接受辅助放射治疗，14 例接受观察。

54 名患者存在治疗前缺陷（84.4%）。手术组的放射学控制率为100%，放射组为97.1%，手术+辅助放射组为69.2%，观察组为90.9%（p  =0.035）。放疗组的症状完全改善为 32.4%，部分改善为 23.1% ( p  = 0.022)。在手术组中，1 名患者症状完全缓解（6.3%），8 名患者部分改善（50.0%），7 名患者没有改善（p  = 0.002）。手术更有可能导致治疗后症状进展（比值比：5.16，置信区间：1.309–20.34）（p  = 0.019）。

结论 放射线具有极好的放射学控制率。对于较大或有症状的病变，手术是一种选择。手术的作用主要是为了保护视力、颅神经减压和肿瘤减灭，在手术前应就治疗目标和期望向患者提供广泛的咨询。