Artikel
Clinical outcome after surgery of tuberculum sellae meningiomas in 72 patients
Ergebnisse nach operativer Behandlung von Tuberculum sellae Meningeome bei 72 Patienten
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Autoren
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M. Nakamura
- Department of Neurosurgery, Klinikum Hannover Nordstadt
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M. Struck
- International Neuroscience Institute, Hannover
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F. Roser
- Department of Neurosurgery, University of Tübingen
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P. Vorkapic
- Department of Neurosurgery, Klinikum Hannover Nordstadt
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M. Samii
- International Neuroscience Institute, Hannover
| Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
Tuberculum sellae meningiomas present a special challenge due to their proximity to arteries of the anterior circulation, anterior visual pathways and hypothalamus. We report the clinical outcome after surgical treatment of tuberculum sellae meningiomas in our neurosurgical department.
Methods
A retrospective study was conducted analysing the patient charts including surgical records, discharge letters, histological records, follow-up records and imaging studies. Patients with associated neurofibromatosis type 2 were excluded from the study.
Results
1800 meningiomas were operated between 1978 and 2002. at our department. Among them, there were 72 patients with tuberculum sellae meningiomas, 4 patients of them with previous surgeries in outside hospitals. There were 55 females and 17 males, the mean age was 54.3 years (30-86 years). Most patients presented with visual disturbance. Tumours were operated through the frontolateral (n=30), pterional/fronto-temporal (n=21) and bifrontal (n=21) approach. Total tumour removal could be achieved in most cases (Simpson 1+2, 91.7%). Perioperative mortality was 2.8% (2 out of 72 patients). Immediate postoperative improvement of visual disturbance was observed in 65% of patients. Visual improvement was dependent on the extent and duration of preoperative visual symptoms. The overall recurrence rate was 2.8% (2 out of 72 patients).
Conclusions
Tuberculum sellae meningiomas were removed through different surgical approaches with comparable clinical results. Although, in recent years we prefer to use the frontolateral approach, which provides quick access to the tumour with less brain exposure, but still enabling total tumour removal with low morbidity rate in most cases.
