title: [Microneurosurgical treatment of massive tuberculum sellae meningiomas].
abstract: OBJECTIVE
  To summarize the characteristics of the pathological anatomy and blood supply model of massive tuberculum sellae meningiomas (MTSM) and explore its corresponding microneurosurgical strategies.
  
  
  METHODS
  The clinical data of 16 MTSM patients were reviewed retrospectively. From January 1998 to January 2010, according to their unique pathological anatomy and blood supply model, all patients underwent microneurosurgical removal with induced hypotension through tumor corridor by the bi-subfrontal anterior longitudinal fission (n = 14), right frontolateral approach (n = 1) and pterional approach (n = 1). There were 5 males and 11 females with a mean age of 48.5 years old (range: 26 - 65). But the mean follow-up period was 74.9 months (range: 4 - 132) in 2/4 cases.
  
  
  RESULTS
  Among all cases, the mean tumor diameter was 58.9 mm (range: 51.1 - 76.2 mm). Simpson grade I, II, III, IV removal of MTSMs were accomplished in 3, 9, 3 and 1 case respectively. One case died within 4 postoperative days. Visual acuity improved in 10 patients, remained unchanged in 2 and deteriorated in 2. Transient postoperative diabetes insipidus occurred in 9 cases.
  
  
  CONCLUSIONS
  It is critical to understand the unique characteristics of pathological anatomy and blood supply model of MTSM so as to adopt proper microneurosurgical strategies to remove it in situ.
authors.affiliation: Department of Neurosurgery, Cancer Institute & Hospital Chinese Academy of Medical Sciences, Beijing 100021, China.
authors.forename: Xue-Ji
authors.initials: XJ
authors.lastname: Li
authors.forename: Jing-Hai
authors.initials: JH
authors.lastname: Wan
authors.forename: Hai-Peng
authors.initials: HP
authors.lastname: Qian
authors.forename: Fu-Xing
authors.initials: FX
authors.lastname: Zuo
authors.forename: Li-Jiang
authors.initials: LJ
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D008866:Microsurgery; D008875:Middle Aged; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D016896:Treatment Outcome