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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Transcranial transsphenoidal approach for tuberculum sellae meningiomas
Acta Neurochirurgica
|August 24, 2000
Summary
This study reports on 21 patients with tuberculum sellae meningioma treated surgically. The described surgical approach offers excellent access and good outcomes for tuberculum sellae meningioma resection.
Area of Science:
- Neurosurgery
- Oncology
Background:
- Tuberculum sellae meningiomas often present with visual disturbances due to their proximity to optic pathways.
- Surgical resection is the primary treatment modality, but achieving adequate exposure can be challenging.
Purpose of the Study:
- To report on the surgical treatment of 21 patients with tuberculum sellae meningioma.
- To evaluate the efficacy and safety of a specific surgical approach for these tumors.
Main Methods:
- A uniform surgical technique involving bicoronal incision, bifrontal craniotomy, and orbital rim removal was used.
- The approach allowed for extensive dissection, including opening of paranasal sinuses and visualization of the tumor's inferomedial extension to the optic nerve.
Main Results:
- Total or near-total tumor resection was achieved in all patients.
- Postoperative visual function improved in 11 patients, remained unchanged in 8, and worsened in 2.
- No operative deaths occurred; cerebrospinal fluid leakage in two patients was managed conservatively. Recurrence was rare (1/21) with a mean 3-year follow-up.
Conclusions:
- The described surgical approach provides excellent clinical value for tuberculum sellae meningioma resection.
- The approach offers superior accessibility to tumors extending inferomedially to the optic nerve, facilitating safe and effective tumor removal.
