Skull Base Approaches for Tuberculum Sellae Meningiomas: Institutional Experience in a Series of 34 Patients

Life

Riad Habib¹  Abu Naim Mohammad Wakil¹  Shamsul Alam¹  Bipin Chaurasia²  Mosiur Rahman Mojumder³  Nazmin Ahmed⁴  Atul Vats⁵  Mohammad Samsul Arifin⁶  Nur Muhammad⁶  Abdullah Al Mahbub⁶  Kazi Mohammad Atiqul Islam⁶  Gianluca Ferini⁷ 

[1] Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Dhaka 1000, Bangladesh;Department of Neurosurgery, Bhawani Hospital and Research Centre, Birgunj 44300, Nepal;Department of Neurosurgery, Comilla Medical College Hospital, Comilla 3500, Bangladesh;Department of Neurosurgery, Ibrahim Cardiac Hospital and Research Institute (A Centre for Cardiovascular, Neuroscience and Organ Transplant Units), Shahbag, Dhaka 1000, Bangladesh;Department of Neurosurgery, James Cook University Hospital, Middlesbrough TS4 3BW, UK;Department of Neurosurgery, National Institute of Neurosciences and Hospital, Agargaon, Dhaka 1207, Bangladesh;Department of Radiation Oncology, REM Radioterapia SRL, Viagrande, 95029 Catania, Italy;

关键词: tuberculum sellae;    skull base;    meningioma;    transsphenoidal;    endoscopy;    microsurgery;   

DOI  :  10.3390/life12040492

来源: DOAJ

【 摘 要 】

(1) Background: The aim of the present study was to evaluate our institutional outcome in tuberculum sellae meningioma (TSM) patients treated microsurgically using multiple skull base approaches, including a transcranial approach and an extended endonasal transsphenoidal approach. (2) Materials and Methods: This is a retrospective study that includes 34 patients with TSM. The study aimed to observe the efficacy of the different common approaches used by a single neurosurgeon. All the patients were evaluated preoperatively and during follow-up with campimetry, head CT scan, and post-contrast MRI. (3) Results: After a transcranial approach, visual acuity improved in 86.20%, was stable in 10.34%, and deteriorated in 3.45%. Through transsphenoidal surgery, vision improved in 80%, was static in 20%, and deteriorated in 0%. Transcranial approaches included pterional, mini-bifrontal basal, and supraciliary keyhole microscopic craniotomies. Gross total removal was performed in 58.82%, near total in 10.34%, and partial removal in 3.45%. The transcranial/supraciliary keyhole endoscopic-assisted approach showed a gross total removal rate of 80%, and near total in 20%. The transsphenoidal approach showed a gross total removal rate of 60%, near total in 20%, and partial removal in 20%. (4) Conclusion: Endoscopic-assisted keyhole supraciliary mini craniotomy for resection of tuberculum sellae meningioma offers low morbidity and good visual outcome. The endonasal route is preferred for the removal of TSM when they are small and midline placed. The major limitation of this approach is a narrow surgical corridor and the restriction on midline-placed lesions. Gross total removal was better achieved with mini-bifrontal basal and pterional craniotomies.

【 授权许可】

Unknown