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Tuberculum sellae meningiomas: surgical considerations
José Alberto Landeiro1, Mariangela Barbi Gonçalves, Rodrigo Dias Guimarães
1Neurosurgery Clinic, Hospital de Força Aérea do Galeão, Rio de Janeiro, RJ, Brazil. jalandeiro@gmail.com
Arquivos De Neuro-Psiquiatria
|July 6, 2010
Summary
Tuberculum sellae meningioma (TSM) surgery using subfrontal supraorbital osteotomy can improve vision. Decompressing the optic canal during TSM resection appears to enhance visual outcomes for patients.
Area of Science:
- Neurosurgery
- Ophthalmology
- Oncology
Background:
- Tuberculum sellae meningiomas (TSMs) are tumors that can compress the optic nerve.
- Optic canal involvement is a critical factor in TSM treatment and prognosis.
- Surgical management aims to resect the tumor while preserving or improving visual function.
Purpose of the Study:
- To evaluate the clinical outcomes of TSM treatment.
- To assess the impact of optic canal decompression on visual function.
- To analyze the effectiveness of the unilateral subfrontal supraorbital osteotomy approach.
Main Methods:
- Retrospective review of 23 patients operated for TSMs between 1997 and 2008.
- Surgical approach: unilateral subfrontal supraorbital osteotomy.
- Techniques included extradural or intradural unroofing of the optic canal to decompress the optic nerve.
Main Results:
- 21 of 23 patients had preoperative visual symptoms.
- Visual acuity improved in 10 patients and visual fields improved or normalized in 17 patients.
- Total resection was achieved in 19 patients; optic canal decompression correlated with better visual outcomes.
Conclusions:
- Unilateral subfrontal supraorbital osteotomy is an effective approach for TSM resection.
- Optic canal decompression during TSM surgery can significantly improve visual outcomes.
- Preservation and improvement of visual function are achievable goals in TSM treatment.
