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Treatment of tuberculum sellae meningiomas:a long-term follow-up study
1Department of Neurosurgery, Kobe University School of Medicine, Kobe City, Japan.
Abstract:
Surgical techniques and their results for tuberculum sellae meningiomas were studied. Thirty-three cases, the first of which was operated in 1980, were analysed. There were 4 men and 29 women with an average age of 46.7 years. Eight cases underwent reoperations. The mean follow-up was 10.7 years. Approaches were pterional for 15 patients, FOZ/FO for 10, bilateral subfrontal for 6, and others for 2. Simpson's grade (I, II, III, IV) were 12, 9, 0, and 12 cases respectively. Recurrence rate was 0% for grade I and 58.3% for grade IV. The FOZ/FO approach resulted in a lower Simpson's grade (P=0.05), but other factors were not related to Simpson's grade (P=0.05). The postoperative visual outcome did not depend on total (grade I and II) or subtotal (grade III and IV) removal (P=0.01). We conclude that radical removal of the tumours may result in lower recurrence rate without increasing surgical complications. Furthermore, skull base approaches can improve the rate of radical removal of tuberculum sellae meningiomas.
Insights
Radical surgical removal of tuberculum sellae meningiomas using skull base approaches can lower recurrence rates. Postoperative visual outcomes are not dependent on the extent of tumor removal.
Area of Science:
- Neurosurgery
- Oncology
Background:
- Tuberculum sellae meningiomas are tumors that can cause visual impairment.
- Surgical techniques aim for complete tumor removal to prevent recurrence.
Purpose of the Study:
- To analyze surgical techniques and outcomes for tuberculum sellae meningiomas.
- To evaluate the impact of surgical approaches on tumor recurrence and visual function.
Main Methods:
- Retrospective analysis of 33 tuberculum sellae meningioma cases operated between 1980 and the study period.
- Evaluation of surgical approaches including pterional, FOZ/FO, and bilateral subfrontal.
- Assessment of Simpson's grade for tumor removal and recurrence rates.
- Analysis of postoperative visual outcomes.
Main Results:
- The FOZ/FO approach was associated with a lower Simpson's grade (P=0.05).
- Recurrence rates were 0% for Simpson's grade I and 58.3% for grade IV.
- Postoperative visual outcome was not significantly dependent on the extent of tumor removal (total vs. subtotal, P=0.01).
Conclusions:
- Radical tumor removal, facilitated by skull base approaches, can reduce recurrence rates without increasing surgical complications.
- Skull base approaches enhance the likelihood of achieving radical removal for tuberculum sellae meningiomas.