Clinical Analysis Of Microsurgical Treatment Of Tuberculum Sellae Meningioma

Objectives:To analyze the clinical features of patients with Tuberculum sellae meningioma,to explore the factors affecting the degree of surgical resection and its relationship with prognosis,to improve the degree of surgical resection of TSMs,and to improve the clinical efficacy and prognosis of patients with Tuberculum sellae meningioma.Methods:Forty-five patients with TSMs who were hospitalized and underwent surgery in the Department of Neurology,the First Affiliated Hospital of Kunming Medical University from December 2015 to March 2018.The age,gender,clinical manifestations,imaging features,surgical and postoperative clinical data,and patient follow-up were collected.The clinical features of patients with Tuberculum sellae meningioma were summarized.The age’ duration,tumor size,and saddle were analyzed by statistical methods.The relationship between internal invasion,vascular nerve bundle and other factors and tumor resection degree,the change of KPS score before and 6 months after surgery was analyzed,and the relationship between surgical resection degree and score change was analyzed.Results:1.Of the 45 patients in this group,34 were female,11 were male,male:female was approximately 1:3.1;patients were aged 29-67 years,with 40-50 years old,with an average of 46.64±7.60,The median age is 45 years old,18 patients(40.0%)with age<45 years old,and 27 patients(60.0%)with age ≥45 years;the course of disease varies from 1 week to 4 years,with an average duration of 10.40±8.62 Months;patients with first-episode symptoms:32 cases of visual acuity,visual impairment,6 cases of headache,4 cases of endocrine dysfunction,1 case of dizziness,1 case of physical examination,1 case of epilepsy.2.In this study,45 patients with TSMs underwent Simpson Ⅰ and Ⅱ resection in 36,Simpson Ⅲ resection in 7 patients,Simpson IV resection in 2 patients,and 21 patients(46.67%)with pathological findings of epithelial type.Statistical analysis showed that tumor size and vascular nerve bundles had an effect on the degree of surgical resection,and the difference was statistically significant(P=0.027;0.044,respectively).3.In this group of 45 patients with postoperative neurological complications were:postoperative urinary collapse in 6 cases,postoperative electrolyte disorder in 7 cases,pituitary dysfunction in 1 ease,olfactory loss in 1 ease,epilepsy in 1 case,no Death cases;32 patients with preoperative visual acuity and visual field impairment,28 patients(87.5%)with dififerent degrees of visual acuity improved after surgery,and 4 patients without change.4.Among the 45 patients who were followed up,29 patients had a KPS score increased 6 months after surgery,and the KPS score was 6 months after the whole cut group.The percentage of cases increased was higher than that of the non-complete cut group.The difference was statistically significant.Meaning(P value is 0.01).Conclusions:Patients with Tuberculum sellae meningioma are more common in women aged 40-50 years.Most of the patients are treated with visual dysfunction.They often have typical imaging findings.The postoperative pathology is mostly in the upper part of the skull.The tumor is located in the deep part of the skull.More complex,tumor size and vascular nerve wrapping can affect the extent of tumor resection.Microsurgical treatment can significantly improve the patient’s vision.The operation should protect the nerves and important blood vessels,and remove the tumor to the greatest extent,which is beneficial to improve the quality of life and improve the prognosis.