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Anterior Interhemispheric Approach for Tuberculum Sellae Meningioma

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Title: Anterior Interhemispheric Approach for Tuberculum Sellae Meningioma
Authors: Terasaka, Shunsuke Browse this author →KAKEN DB
Asaoka, Katsuyuki Browse this author
Kobayashi, Hiroyuki Browse this author
Yamaguchi, Shigeru Browse this author
Keywords: Anterior interhemispheric approach
Surgical removal
Tuberculum sellae meningioma
Visual impairment score
Visual outcome
Issue Date: Mar-2011
Publisher: Congress of Neurological Surgeons
Journal Title: Neurosurgery
Volume: 68
Issue: Operative Neurosurgery, 1
Start Page: ons84
End Page: ons89
Publisher DOI: 10.1227/NEU.0b013e31820781e1
PMID: 21206321
Abstract: Objective: We retrospectively analyzed patients with tuberculum sellae meningiomas (TSM) who underwent surgery via an anterior interhemispheric approach with special attention to visual outcomes. Patients and Methods: Nine consecutive patients between April 2004 and December 2009 were examined. Visual impairment score (VIS) was used to analyze the visual status of the patients. A VIS is the sum of the scores in specific tables for visual acuity and visual field defects. Visual status was sequentially evaluated in the preoperative period and within two weeks of the operation. Any change in the VIS was considered to be an improvement or deterioration of visual function. All tumors were removed via an anterior interhemispheric approach. Following the wide dissection of the interhemispheric fissure, the tumor was first detached from its origin and debulked with the ultrasonic aspirator starting at the midline. The debulking continued until the arachnoid plane separating the nerve and tumor was visualized. Results: Gross total resection (Simpson I+II) was achieved in all nine patients. The average VIS was 56.1 preoperatively and 26.3 in the postoperative period. Among nine patients, eight patients had an improvement of the VIS after surgery. VIS was unchanged in one patient and no patients experienced visual deterioration. Other non-visual complications, such as rhinoliquorrhea, venous infarction and permanent anosmia occurred in three patients. Conclusion: Despite the small number of patients, a high resection rate and favorable visual outcome support the suitability of this approach for resection of TSM.
Rights: This is a non-final version of an article published in final form in Neurosurgery, Mar. 2011, 68(Operative Neurosurgery, 1), pp. ons84-ons89
Type: article (author version)
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 寺坂 俊介

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