Anterior Interhemispheric Approach for Tuberculum Sellae Meningioma

2011 ◽  
Vol 2011 ◽  
pp. 206-207
Author(s):  
J.K. Liu
Keyword(s):  
Tuberculum Sellae Meningioma ◽  
Interhemispheric Approach ◽  
Anterior Interhemispheric Approach ◽  
Tuberculum Sellae

scholarly journals Anterior Interhemispheric Approach for Tuberculum Sellae Meningioma

2011 ◽  
Vol 68 (suppl_1) ◽  
pp. ons84-ons89 ◽  
Author(s):  
Shunsuke Terasaka ◽  
Katsuyuki Asaoka ◽  
Hiroyuki Kobayashi ◽  
Shigeru Yamaguchi
Keyword(s):  
Visual Outcome ◽  
Visual Field Defects ◽  
Preoperative Period ◽  
Tuberculum Sellae Meningioma ◽  
Interhemispheric Approach ◽  
Visual Status ◽  
Number Of Patients ◽  
Impairment Score ◽  
Anterior Interhemispheric Approach ◽  
Tuberculum Sellae

Abstract BACKGROUND: The tuberculum sellae meningioma (TSM) arises from the tuberculum sellae, chiasmatic sulcus, and limbus sphenoidale. OBJECTIVE: To retrospectively analyze patients with TSM who underwent surgery via an anterior interhemispheric approach, with special attention to visual outcomes. METHODS: Nine consecutive patients between April 2004 and December 2009 were examined. Visual impairment score (VIS) was used to analyze the visual status of the patients. A VIS is the sum of the scores in specific tables for visual acuity and visual field defects. Visual status was sequentially evaluated in the preoperative period and within 2 weeks of the operation. Any change in the VIS was considered an improvement or deterioration of visual function. All tumors were removed via an anterior interhemispheric approach. Following the wide dissection of the interhemispheric fissure, the tumor was first detached from its origin and debulked with the ultrasonic aspirator starting at the midline. The debulking continued until the arachnoid plane separating the nerve and tumor was visualized. RESULTS: Gross total resection (Simpson I + II) was achieved in all 9 patients. The average VIS was 56.1 in the preoperative period and 26.3 in the postoperative period. Among 9 patients, 8 patients had an improvement of the VIS after surgery. VIS was unchanged in 1 patient, and no patients experienced visual deterioration. Other nonvisual complications, such as rhinoliquorrhea, venous infarction, and permanent anosmia, occurred in 3 patients. CONCLUSION: Despite the small number of patients, a high resection rate and favorable visual outcome support the suitability of this approach for resection of TSM.

Validation of the superior interhemispheric approach for tuberculum sellae meningioma

2012 ◽  
Vol 117 (6) ◽  
pp. 1013-1021 ◽  
Author(s):  
Sophie Curey ◽  
Stéphane Derrey ◽  
Pierre Hannequin ◽  
Didier Hannequin ◽  
Pierre Fréger ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Early Postoperative Period ◽  
Csf Leak ◽  
Karnofsky Performance Scale ◽  
Tuberculum Sellae Meningioma ◽  
Interhemispheric Approach ◽  
Tuberculum Sellae ◽  
Surgical Corridor ◽  
The Impact

Object The objective of this study was to evaluate the ophthalmological outcome, nonvisual morbidity, and surgical complications after tuberculum sellae meningioma (TSM) removal using a superior interhemispheric approach. Methods In the last decade, 20 consecutive patients with TSM underwent operations using the superior interhemispheric approach. Visual acuity, visual field, and ocular fundus examination were assessed both preoperatively and 6-months postoperatively. Nonvisual morbidity was determined at an early postoperative period and at 6 months based on assessment of the Karnofsky Performance Scale score, leakage of CSF, endocrinological status, and olfactory function, which was assessed using a visual analog scale (VAS). The potential brain injury related to the approach was assessed by MRI at 6 months. Magnetic resonance imaging was then performed yearly to detect a recurrence. The mean follow up was 56.3 ± 34 months. Results The primary presenting symptom for diagnosis of TSM in 20 patients (female:male ratio of 6.6:1, mean age 59.1 ± 11.1 years) was visual disturbance in 12 patients (60%), headache in 4 (20%), cognitive alteration in 1 (5%), epilepsy in 2 (10%), and accidental in 1 (5%). In a total of 40 eyes, 17 eyes in 11 patients presented with preoperative deterioration of visual acuity. Postoperatively, the visual acuity improved in 13 eyes in 8 patients (72.8%), remained unchanged in 3 eyes in 2 patients (18.2%) and deteriorated in 1 patient (9%). The nonvisual morbidity included olfactory deterioration in 7 patients (35%), and panhypopituitarism in 1 patient (5%). No patients experienced a CSF leak. The impact of olfactory deterioration on the quality of life, as estimated by a VAS score (range 0–10), was a mean of 5.7 ± 2.2 (95% CI 4.1–7.3). On the follow-up MRI, no additional lesions or recurrences were observed on the medial aspect of the frontal lobe along the surgical corridor. Conclusions The superior interhemispheric approach appears to be effective in resolving the problem of visual deterioration due to a TSM, without inducing surgical injury on the brain surface along the surgical corridor. Olfactory deterioration remained the challenging predominant nonvisual morbidity using this approach.

scholarly journals How I do it: endoscopic endonasal resection of tuberculum sellae meningioma

2021 ◽  
Author(s):  
Markus Wiedmann ◽  
Aslan Lashkarivand ◽  
Jon Berg-Johnsen ◽  
Daniel Dahlberg
Keyword(s):  
Team Approach ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Ongoing Debate ◽  
Endoscopic Endonasal ◽  
Microsurgical Technique ◽  
Tuberculum Sellae Meningioma ◽  
Tuberculum Sellae ◽  
Dedicated Team ◽  
Neurovascular Structures

Abstract Background Tuberculum sellae meningiomas (TSMs) adherent to neurovascular structures are particularly challenging lesions requiring delicate and precise microneurosurgery. There is an ongoing debate about the optimal surgical approach. Method We describe technical nuances and challenges in TSM resection using the endoscopic endonasal approach (EEA) in two cases of fibrous tumors with adherence to neurovascular structures. The cases are illustrated with a video (case 1) and figures (cases 1 and 2). Conclusion A dedicated team approach and precise microsurgical technique facilitate safe resection of complex TSMs through the EEA.

Surgical management of tuberculum sellae meningioma: Role of selective extradural anterior clinoidectomy

2006 ◽  
Vol 20 (3) ◽  
pp. 129-138 ◽  
Author(s):  
Naoki Otani ◽  
Carl Muroi ◽  
Hirohito Yano ◽  
Nadia Khan ◽  
Athina Pangalu ◽  
...  
Keyword(s):  
Surgical Management ◽  
Tuberculum Sellae Meningioma ◽  
Anterior Clinoidectomy ◽  
Tuberculum Sellae

Surgical Management of Tuberculum Sellae Meningioma: Our Experience and Review of the Literature

2021 ◽  
Vol 69 (6) ◽  
pp. 1592
Author(s):  
SureshK Sankhla ◽  
Narayan Jayashankar ◽  
MaqsoodA Khan ◽  
GhulamM Khan
Keyword(s):  
Surgical Management ◽  
Review Of The Literature ◽  
Tuberculum Sellae Meningioma ◽  
Tuberculum Sellae

scholarly journals Microsurgical Anatomy of the Superficial Cortical Veins of the Frontal Lobe in Anterior Interhemispheric Approach(Interhemispheric Approach)

1992 ◽  
Vol 1 (3) ◽  
pp. 201-206
Author(s):  
Kazunari Oka ◽  
Fumiaki Maehara ◽  
Masaaki Yamamoto ◽  
Hideo Kimura ◽  
Masamichi Tomonaga ◽  
...  
Keyword(s):  
Frontal Lobe ◽  
Microsurgical Anatomy ◽  
Interhemispheric Approach ◽  
Anterior Interhemispheric Approach

Ruptured anterior communicating artery aneurysm encased in a tuberculum sellae meningioma

1999 ◽  
Vol 91 (5) ◽  
pp. 871-874 ◽  
Author(s):  
Masahiro Ogino ◽  
Masashi Nakatsukasa ◽  
Toru Nakagawa ◽  
Ikuro Murase
Keyword(s):  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Anterior Communicating Artery ◽  
Resonance Imaging ◽  
Content Type ◽  
Intratumoral Hemorrhage ◽  
Tuberculum Sellae Meningioma ◽  
Anterior Communicating Artery Aneurysm ◽  
Preoperative Magnetic Resonance ◽  
Tuberculum Sellae

✓ This 70-year-old woman suffered a subarachnoid hemorrhage (SAH) from a ruptured anterior communicating artery aneurysm encased in a meningioma in the tuberculum sellae. Although preoperative magnetic resonance imaging disclosed that the aneurysmal complex was completely enclosed in the tumor, angiographic studies did not reveal arterial narrowing. The embedded aneurysm caused diffuse SAH rather than intratumoral hemorrhage. These factors indicated very little adhesion between the tumor and the encased arteries. Surgery was performed on the 20th day post-SAH. Intraoperative findings revealed that the tumor did not adhere to the enclosed vasculature except at the point of rupture of the aneurysm. The authors were able to clip the aneurysm safely after piecemeal removal of the tumor, which was finally extirpated without fear of aneurysm rupture. Careful stepwise procedures were essential to treat the aneurysm and the tumor simultaneously.

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