+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Microsurgical management of tuberculum sellae meningiomas by the frontolateral approach: surgical technique and visual outcome



Microsurgical management of tuberculum sellae meningiomas by the frontolateral approach: surgical technique and visual outcome



Clinical Neurology and Neurosurgery 113(1): 39-47



The aim of this study was to evaluate visual outcome in patients with tuberculum sellae meningioma (TSM) treated microsurgically using the frontolateral or fronto-orbital approach and optic canal unroofing to resect tumor involvement of the optic canal. Data from 67 patients with TSMs who underwent microsurgical treatment by a frontolateral approach (n=44) or fronto-orbital approach (n=23) between January 2002 and December 2008 were retrospectively collected and analyzed. Change in visual function was evaluated as the main outcome. Total tumor resection was achieved in 62 of 67 cases (92.4%). Postoperative, visual acuity was improved in 87 eyes (64.9%) and unchanged in 39 eyes (29.1%), and the optic nerve was therefore preserved in 126 of 134 eyes (94.0%). Visual field deficits were improved or stable in 65 eyes, no patient experienced worsening of vision in both eyes. There was no mortality in our series. The frontolateral approach with microsurgical dissection of the Sylvian fissure provides quick access to TSMs, which can be resected safely and totally. Visual function is improved and neurological and ophthalmological morbidity is minimal. Optic nerve decompression by intradural clinoidectomy and optic canal unroofing is likely to increase the rate of reducing or eliminating preoperative visual symptoms.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 054380500

Download citation: RISBibTeXText

PMID: 20947247

DOI: 10.1016/j.clineuro.2010.08.019


Related references

Tuberculum sellae meningiomas: surgical technique, visual outcome, and prognostic factors in 51 cases. Journal of Neurological Surgery. Part B, Skull Base 74(4): 247-258, 2014

Tuberculum sellae meningiomas: microsurgical anatomy and surgical technique. Neurosurgery 51(6): 1432-39; Discussion 1439-40, 2002

Surgical management of tuberculum sellae meningiomas: involvement of the optic canal and visual outcome. Journal of Neurology, Neurosurgery, and Psychiatry 76(7): 977-983, 2005

Surgically treated tuberculum sellae and diaphragm sellae meningiomas: the importance of short-term visual outcome. Neurosurgery 59(2): 238-43; Discussion 238-43, 2006

Fronto-basal interhemispheric approach for tuberculum sellae meningiomas; long-term visual outcome. British Journal of Neurosurgery 23(4): 422-430, 2009

Bilateral subfrontal approach for tuberculum sellae meningiomas in long-term postoperative visual outcome. Journal of Neurosurgery 115(4): 802-810, 2011

Microsurgical management of tuberculum sellae meningiomas. Zhonghua Yi Xue Za Zhi 90(33): 2348-2350, 2010

The contralateral subfrontal approach can simplify surgery and provide favorable visual outcome in tuberculum sellae meningiomas. Neurosurgical Review 35(4): 601-7; Discussion 607-8, 2012

Extended transsphenoidal microsurgical approach for diaphragma sellae and tuberculum meningiomas. Minimally Invasive Neurosurgery 52(5-6): 267-270, 2010

Microsurgical Treatment of Tuberculum Sellae Meningiomas with Visual Impairments: A Chinese Experience of 56 Cases. Turkish Neurosurgery 26(1): 48-53, 2016

Planum Sphenoidale and Tuberculum Sellae Meningiomas: Operative Nuances of a Modern Surgical Technique with Outcome and Proposal of a New Classification System. World Neurosurgery 86: 270-286, 2016

Microsurgical management of tuberculum sellae meningiomas. Results in 28 consecutive cases. Surgical Neurology 26(1): 37-44, 1986

Microsurgical removal of huge tuberculum sellae meningiomas through bi-subfrontal anterior longitudinal fission approach. Nan Fang Yi Ke Da Xue Xue Bao 30(7): 1688-1690, 2010

Visual outcome after fronto-temporo-orbito-zygomatic approach combined with early extradural and intradural optic nerve decompression in tuberculum and diaphragma sellae meningiomas. Clinical Neurology and Neurosurgery 114(6): 597-606, 2012

Olfactory and tuberculum sellae meningiomas--surgical technique. No Shinkei Geka. Neurological Surgery 2(4): 283-288, 1974