title: Tuberculum sellae meningiomas: surgical considerations.
abstract: We report our experience on the treatment of tuberculum sellae meningiomas (TSMs) regarding the involvement of the optic canal and clinical outcomes. We reviewed 23 patients who were operated on between January 1997 and December 2008. The surgical approach was unilateral subfrontal supraorbital osteotomy in one piece. Attempts were made to improve visual function via extra/intradural unroofing of the optic canal, which released the optic nerve. Visual symptoms were present preoperatively in 21 patients, and two patients were asymptomatic. Visual acuity remained intact in 6 patients, improved in 10, was unchanged in 5 patients, and worsened in 2 patients. The postoperative visual field was normal or improved in 17 patients, unchanged in four patients, and worsened in two patients. The optic canal and clinoid were drilled extradurally in eight patients and intradurally in nine patients. Total resection of TSMs was achieved in 19 patients. Incomplete resection occurred in two patients. Decompression of the optic canal seemed to increase the visual outcome.
authors.affiliation: Neurosurgery Clinic, Hospital de Força Aérea do Galeão, Rio de Janeiro, RJ, Brazil. jalandeiro@gmail.com
authors.forename: José Alberto
authors.initials: JA
authors.lastname: Landeiro
authors.forename: Mariangela Barbi
authors.initials: MB
authors.lastname: Gonçalves
authors.forename: Rodrigo Dias
authors.initials: RD
authors.lastname: Guimarães
authors.forename: João
authors.initials: J
authors.lastname: Klescoski
authors.forename: Jorge Luiz Amorim
authors.initials: JL
authors.lastname: Correa
authors.forename: Mário Alberto
authors.initials: MA
authors.lastname: Lapenta
authors.forename: Orlando
authors.initials: O
authors.lastname: Maia
mesh_terms: D000328:Adult; D000368:Aged; D003399:Craniotomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D012658:Sella Turcica; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014792:Visual Acuity