Microsurgical Operative Treatment To Tuberculum Sellae Meningiomas

Objective: To conclude the clinical and anatomic characters of tuberculum sellae meningiomas;To investigate microsurgical techniques, operative effect and postoperative complications in cases of tuberculum sellae meningiomas. It will be helpful to the treatment followed to summarize experience.Methods: Review the 49 cases of Tubereulum sellae Meningiomas from June, 2002 to June 2009 in our department and analyze their epidemiology, clinical symptoms, neuroimaging features, surgical approaches curative effects and postoperative complications.Results: All the 49 cases were operated on using microsurgical techniques under general anesthesia.The patients were operated on via diferent approaches,including subfrontal in 14 cases,pterional in 26 cases ,unifrontal-pterional 7 cases and transfrontal interhemispheric in 2 cases. Complete resection (Simpson I or II grade) was achieved in 47 out of 42 (85.7%),subtotal resection in 7 patients(14.3%). 1 of the 49 cases died,The rate of postoperative morbidity is 30.6%.The improvement rate in vision was 81.6%.the follow up period of 33 patients ranged from 3 months-7 years.There are 2 recurrent cases.Surgical effects were satisfying.Conclusion:1. Using microsurgical technique, understand relevant microdissection, choose right approach and good preoperative preparation will enhance the cure rate, reduce operative mortality and decrease regrowth.2.The postoperative complications can be reduced significantly by using appropriate operative approach and skillful surgical technique so as to avoid the direct injury of the structure of optic nerves,optic chiasma,hypothalamus and pituitary stalk,and the injury of the perforating blood-supply artery.3. The less duration of visual compromise lasted, the more favorable postoperative recovery.