open access

https://hdl.handle.net/2115/48489

Anterior Interhemispheric Approach for Tuberculum Sellae Meningioma

英語

Visual outcome

2011-03

Congress of Neurological Surgeons

Neurosurgery

68(Operative Neurosurgery, 1)

ons84-ons89

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.

学術雑誌論文

Accepted Manuscript

This is a non-final version of an article published in final form in Neurosurgery, Mar. 2011, 68(Operative Neurosurgery, 1), pp. ons84-ons89

0148-396X