Document Detail


Fronto-basal interhemispheric approach for tuberculum sellae meningiomas; long-term visual outcome.
MedLine Citation:
PMID:  19637015     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report our experience with the treatment of tuberculum sellae meningiomas using the fronto-basal interhemispheric approach. A retrospective analysis was performed on a series of 24 patients with tuberculum sellae meningiomas who were operated between March 2000 and January 2007. Patients' presenting symptoms, radiological images, operative reports, and clinical follow-up data were reviewed with special consideration for visual outcome. Visual deterioration was the presenting symptom in all patients, followed by headache in 9 patients (37.5%). The average duration of visual symptoms was 17.6 months. The average tumor diameter was 2.63 cm; encasement of the carotid artery was identified in 7 patients (29%). Complete tumor removal was achieved in 21 patients (87.5%). Mean follow-up period was 52 months. Vision improved in 19 patients (79%), remained stable in 4 (17%) and deteriorated in 1 patient (4%). The degree of tumor removal or visual outcome were both unrelated to the tumor size (p = 0.2 and p = 0.6 respectively). While the degree of preoperative visual deficit did not affect the visual improvement rate in the whole group (p = 0.9), those patients with improvement to good functional vision (>20/40) after the surgery, had a less severe preoperative deficit (p < 0.001). The most common complication was anosmia (29.1%) and there was no mortality. The frontobasal interhemispheric approach is safe and provides a direct anatomical approach to tuberculum sellae meningiomas with relatively low incidence of complications. Patients with improved vision to good functional level had a better preoperative visual status.
Authors:
Ahmed Ganna; Amir R Dehdashti; Konstantina Karabatsou; Fred Gentili
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British journal of neurosurgery     Volume:  23     ISSN:  1360-046X     ISO Abbreviation:  Br J Neurosurg     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-28     Completed Date:  2009-12-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8800054     Medline TA:  Br J Neurosurg     Country:  England    
Other Details:
Languages:  eng     Pagination:  422-30     Citation Subset:  IM    
Affiliation:
Division of Neurosurgery, Toronto Western Hospital, UHN, University of Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Humans
Magnetic Resonance Imaging
Male
Meningeal Neoplasms / complications,  surgery*
Meningioma / complications,  surgery*
Middle Aged
Olfaction Disorders / epidemiology,  etiology
Retrospective Studies
Sella Turcica
Treatment Outcome
Vision Disorders / epidemiology,  etiology,  surgery*
Visual Acuity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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