Journal
SURGICAL NEUROLOGY
Volume 66, Issue 1, Pages 37-45Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.surneu.2005.11.059
Keywords
brain neoplasm; endocrine function; meningioma; suprasellar tumor; tuberculum sellae; visual outcome
Categories
Ask authors/readers for more resources
Objective: The objective of this study was to analyze a series of patients harboring a tuberculum sellae meningioma with regard to clinical presentation and long-term functional outcome. Methods: Data in a consecutive series of 62 patients harboring a tuberculum sellae meningioma treated microsurgically between 1990 and 2003 were retrospectively reviewed. Results: The mean age of the 46 women and 16 men enrolled in the study was 53 years (range 29-81 years). The presenting symptom was visual compromise in 87.1% of the patients, and examination revealed decreased visual acuity in 79% and impaired visual fields in 64.5% of the patients. In addition, 14.5% of the patients had preoperative hormonal abnormalities. Simpson grades I and 11 resections, usually via a pterional approach, were achieved in 90.3% of the patients. Postoperatively, vision improved in 53.2%, remained unchanged in 29.8%, and deteriorated in 17.0% of the patients. The intraoperative finding predicting an unfavorable visual outcome was a thin atrophic optic nerve, encasement of the nerve, or tumor adhesion to its undersurface. Of the patients, 12.9% required permanent postoperative hormonal replacement. After a mean follow-up period of 6.0 years (range = 18 months-14 years), 88.7% of the patients resumed normal life activity and 2 recurrent tumors were observed (3.2%) and reoperated. Conclusions: Preoperative magnetic resonance imaging provides reliable information with regard to dislocation of critical vascular structures. However, the relationship between optic nerves and tumors (eg, adhesion and encasement) affected postoperative results and can only be fully appreciated during microsurgery. Visual outcome may be improved by preserving the microvasculature supplying the optic apparatus. (c) 2006 Elsevier Inc. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available