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Surgery for diaphragma sellae meningioma: how I do it
Amani Belouaer1, Daniele Starnoni1, Roy Thomas Daniel2,3
1Department of Neurosurgery, University Hospital of Lausanne (CHUV), rue du Bugnon 46, 1011, Lausanne, Switzerland.
Background:
Surgery for diaphragma sellae meningiomas (DSM) remains challenging due to the intimate neurovascular relationships of the tumor. Excision of DSM along with a decompression of the optic apparatus requires a good knowledge of the skull base anatomy and a precise preoperative evaluation of the tumor extensions.
Method:
We describe the key steps of transcranial approach for DSM with a video illustration. The surgical anatomy is described along with the advantages and limitations of this approach.
Conclusions:
The transcranial approach allows a safe tumor excision with an early and adequate control of the neurovascular structures, while minimizing postoperative CSF rhinorrhea.
