[Microsurgical removal of huge tuberculum sellae meningiomas through bi-subfrontal anterior longitudinal fission approach].
OBJECTIVE
To summary the microsurgical techniques for removal of huge tuberculum sellae meningiomas through the bi-subfrontal anterior longitudinal fission approach.


METHODS
Eleven patients with huge tuberculum sellae meningiomas underwent microsurgical removal of the meningiomas between January, 2005 and November, 2009. The microsurgical techniques were summarized, and the factors affecting the prognosis were analyzed.


RESULTS
Among all the patients, 5 had Simpson grade I meningioma removal and the other patients had Simpson grade II removal. No death occurred in these patients. Nine patients showed vision improvement after the surgery, one had no significant improvement, and the other one experienced worsening of vision. Transient postoperative diabetes insipidus occurred in 5 cases.


CONCLUSIONS
With satisfactory exposure of Dorsum sellae, bottom of the third ventricle and cavernous sinus, the bi-subfrontal anterior longitudinal fission approach is suggested for treatment of tuberculum sellae meningiomas. The key to improve the GTR and reduce the complication lies in the sequence of the operation, namely resection of the tumoral basement before dissection of the potential arachnoidal space and tuberculum.
Xu
Yi-min
YM
Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. xuym777@163.com
Qi
Song-tao
ST
Pan
Jun
J
Lu
Yun-tao
YT
Fan
Jun
J
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000473:pathology / Q000601:surgery*; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D012658:Sella Turcica / Q000473:pathology; D016896:Treatment Outcome