THE OPERATION OF TUBERCULUM SELLAE MENINGIOMA / 解放军医学杂志

ABSTRACT

Tuberculum sellae meningioma comprises 5% to 10% of intracranial meningioma. Its surgery pays attention to operating procedures for it's special location. All the 29 cases underwent surgery via different approachs between May 1992 and September 2001. There were 6 men and 23 women, The mean age was 46 years (27～68 years). The mean size of the tumor was 3 4 cm (2 0～8 5cm). The primary symptoms were a progressive visual loss (72 4%), headache (24 1%) and seizure (3 4%).Tuberculum sellae meningiomas were approached through four cranial bone flaps pterional approach in 13 cases, subfrontal approach in 11 cases, supraorbital approach in 3 cases and bilateral subfrontal approach in 2 cases. Complete tumor resection was done in 26 cases (89 7%)(Simpson's grade Ⅰ), subtotal surgical removal in 3 cases(10 3%)(Simpson's grade Ⅱ). No death occurred. Regardless of which surgical approach is selected, it is necessary to pay attention to the normal anatomical relationship and functions of the sellae region. The neurosurgeon must have skillful microneurosurgical techniques. On the other hand, identification of the normal structures and tumor capsule plays a role in protecting the important vessels, optic nerves and hypothalamus.