Endoscopic Supraorbital Eyebrow Approach for Medium-Sized Tuberculum Sellae Meningiomas: A Cadaveric Stepwise Dissection, Technical Nuances, and Surgical Outcomes.
World Neurosurg
; 176: e40-e48, 2023 Aug.
Article
en En
| MEDLINE
| ID: mdl-36940807
ABSTRACT
BACKGROUND:
Tuberculum sellae meningiomas (TSMs) have traditionally been removed using a transcranial approach. In recent years, endoscopic surgery for TSMs has been reported with an expansion of indications.OBJECTIVE:
We have performed a fully endoscopic supraorbital keyhole approach for small to medium-sized TSMs and performed radical tumor removal similar to conventional transcranial procedure. We report the details of this surgical procedure including cadaveric stepwise dissection and initial surgical results for small to medium-sized TSMs.METHODS:
We used an endoscopic supraorbital eyebrow approach for 6 patients with TSMs between September 2020 and September 2022. Mean tumor diameter was 16.0 mm (range, 10-20 mm). The surgical approach included an eyebrow skin incision ipsilateral to the lesion, a small frontal craniotomy, subfrontal exposure of the lesion, removal of the tuberculum sellae, unroofing of the optic canal, and resection of the tumor. The extent of resection, preoperative and postoperative visual function, complications, and operative time were evaluated.RESULTS:
Optic canal involvement was observed in all patients. Two patients (33%) showed visual dysfunction before surgery. Simpson grade 1 tumor resection was achieved in all cases. Visual function was improved in 2 cases, and remained unchanged in 4 cases. Postoperative pituitary function was preserved in all cases, with no decreases in olfaction.CONCLUSIONS:
The endoscopic supraorbital eyebrow approach for TSMs allowed resection of the lesion, including tumor extending to the optic canal, with a good surgical view. This technique is minimally invasive for patients and may represent a good surgical option for medium-sized TSMs.Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Neoplasias de la Base del Cráneo
/
Neoplasias Meníngeas
/
Meningioma
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
World Neurosurg
Asunto de la revista:
NEUROCIRURGIA
Año:
2023
Tipo del documento:
Article