30/F otherwise healthy had right sided complete 3rd nerve palsy. MRI/MRA revealed meningioma at cavernous sinus region compressing ICA? Vision is intact. Other cranial nerves were intact.
Right frontotemporoparietal Craniotomy and subtemporal approach will give panoramic view. Minimum use of diathermy. May need to leave some tumour behind but can achieve total excision if soft and suckable
Impossible to advise without imaging studies for review first , completeness of excision needs to be balanced against new neural damage, if CN3 is gone then all others in lat cavernous wall at risk,
even with a closed lid her diplopia will already be a significant irreversible deficit the real risk is the encasement or not, of the internal carotid artery
if extensive invasion stops short of the chiasm radiation as a standalone option may be worth considering
Agree with the previous answer,
I will add the consideration of Orbitozygmatic approach and decompression of the cavernous sinus and the superior orbital fissure then go for radiation.
But again you need much more details then what you have here including Neuroimaging
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