[Suprasellar tumors in patients over 70 years of age. Value of limited frontotemporal craniotomy. Visual results. Apropos of 5 cases].
The authors report their experience of the surgical approach for suprasellar tumors (Jugum or tuberculum sellae meningiomas, 3 cases, and suprasellar craniopharyngiomas, 2 cases) in over than seventy years old patients (71-78 y). A limited craniectomy was performed at the fronto-temporal junction using three adjacent burr-holes. The duramater was cut with an Y-shaped incision. Cerebrospinal fluid was sucked out through a lateral subfrontal route, allowing an easy cerebral collapse in elderly patients, which can sometimes avoid even retraction. Such an supra-orbital craniectomy allowed a subfrontal approach, opening of the sylvian fissure and control of the inter optic, inter carotido-optic and latero-carotidian spaces as well as a good access to the inter pedoncular cistern. In 4 cases the craniectomy was performed after fronto-temporal skin incision, but a trans eyebrow skin incision was used in 1 case. All patients had uneventful postoperative course. Follow-up was from 3 to 5 years. A visual improvement occurred in all cases. Benefits of this surgical method are discussed and compared with use of a bone flap in patients over than 70 years.
Van Effenterre
R
R
Service de neurochirurgie, Hôpital de la Pitié, Paris.
Van Effenterre
G
G
Cabanis
E A
EA
Iba Zizen
M T
MT
D000368:Aged; D003397:Craniopharyngioma / Q000175:diagnosis / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005624:Frontal Bone; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000175:diagnosis / Q000601:surgery*; D015173:Supratentorial Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013701:Temporal Bone; D014057:Tomography, X-Ray Computed; D014794:Visual Fields
Tumeurs supra-sellaires chez les sujets agés de plus de 70 ans. Intérêt d'une crâniectomie fronto-temporale limitée. Résultats visuels. A propos de 5 cas.