Analysis Of The Main Factors Affecting The Prognosis Of Postoperative Visual Outcome In Patient With Tuberculum Sellea Meningiomas

Background:Tuberculum sellae meningiomas treatment has been challenging due to their close intimacy with critical structures, optic nerves and chiasma, hypothalamus, and internal carotid arteries and threat of neurovascular encasementObjective:The goal of this study is to analyze the visual outcomes affected by the main prognostic factors (14factors) affecting visual outcome.Materials and Methods:we retrospectively analyzed57Patients treated in Wuhan city Tongji hospital from January2008to march2012on the basis of clinical, radiological, and surgical factors that might appear to affect the visual outcome either uniocular and/or binocular with special attention to factors such as age,sex, tumor location, extent of resection, recurrence, surgical approach, tumor blood supply, peritumoral edema, tumor size, duration of visual symptoms, tumor texture, tumor location, involvement with optic canal and orbit, preoperative vision, and headache.Selection criteria:all cases had pre-op Visual acuity decrease and were diagnosed by imaging, surgical findings and pathology confirmation. Statistical Analysis UsedSPSS system for Comparison of categorical variables between the factors and visual outcome was performed using chi-square test and a P value of≤0.05was considered significant. Logistic regression was used when multivariate analysis was required.ResultsPost-op uniocular visual acuity was improved in71eyes (62.28%), no significant changes in26eyes (22.8%) and deteriorated in17eyes (14.91%).in univariate analysis we found that age, extent of resection, recurrence, symptoms duration, pre-op vision, tumor size,texture and location, preitumorl edema and tumor blood supply were significantly affecting the visual outcome, in multivariate analysis we found that recurrence, duration of symptoms, tumor size and texture were the independently risk factors affecting the visual outcome improvement.ConclusionsTumor recurrence, duration of symptoms and signs, tumor size and texture are independently risk factors for visual deterioration. Surgical approach and skillful techniques have less effect on visual outcomes.