Tuberculum Sellae Meningiomas: Surgical Results and Outcome in 30 Cases

[摘要] Background: Tuberculum sellae meningiomas comprise approximately 5-10% of intracranial meningiomas. Objective: The objective of this study was to analyze surgical and functional outcome in a series of patients harboring tuberculum sellae meningioma and whether it was related to the type of approach used. Methods: Thirty patients with tuberculum sellae meningioma treated microsurgically between 2005 and 2009 were retrospectively reviewed. Results: The study included 17 women and 13 men with a mean age of 48 years (range = 34-63 years). Visual compromise was the commonest symptom in 83% of the patients, and examination revealed decreased visual acuity in 73% and impaired visual fields in 60% of the patients. Simpson grades I and II resections, via a pterional and lateral supraorbital approaches, were achieved in 83% of the patients. Postoperatively, vision improved in 53.5%, remained unchanged in 25%, and deteriorated in 21.5% of the patients. Complications included anosmia and CSF leak which were more common in lateral supraorbital approach, while vascular injury and diabetes insipidus were more pronounced in pterional approach. Endocrine disturbances did not play a major role, neither preoperatively nor postoperatively, but may be a more important factor in very large tumors. After a mean follow-up period of 30 months (range = 6 -48 months), 86% of the patients resumed normal life activity and 1 recurrent tumor was observed (3.3%) and re-operated. Conclusions: Considering the operative morbidity and mortality, the lateral supraorbital and pterional approaches provide remarkable improvement. These approaches allow quick access to the tumors and are minimally invasive, with less brain exposure, but still enable high rates of total tumor removal. [Egypt J Neurol Psychiat Neurosurg.  2010; 47(4): 549-554]

[学科分类] 精神健康和精神病学