Visual Recovery with Surgical Managment of Suprasellar Meningioma

ABSTRACT

The visual outcome in consecutive 16 cases of suprasellar meningioma treated during the past 7 years was reivewed. Progressive visual loss, the most frequent initial complant(93.8%), occurred over a mean of 35.4 months, was often unilateral(6 patients) or bilateral but asymmetrical(6 patients) and was severe in 12 cases. All 16 patients hadvisual field abnormalities. There were 9 patients with tumors lager than 3cm in diameter and 7 patients with tumors less than 3cm in diameter. Four patients had tumors limited to the tuberculum sellae. The tumors extended from the tuberculum sellae onto the planum sphenoidale in four patients. into one optic canal in three patients, onto the diaphragm sellae in four patients and onto the medial sphenoid wing in one patient. Three tumors were incompletely resected(one involoving the medial sphenoid wing, one involving the diaphragm sellare and one involving the lanum sphenoidale). There was one operative death. Overall, 73% of patients had improved vision postoperatively, 27% remained unchanged. Tumor invoving the diaphragm sellae was associated with postoperative visual field deterioration. The visual outcome was affected by the severity of preoperative visual loss but not by the tumor size and duration of visual symptom. After a mean follow-up of 14.5 months, 15 patients are performing normal activities with improved vision.