High incidence of optic canal involvement in tuberculum sellae meningiomas: rationale for aggressive skull base approach

Surgical Neurology
Burak Sade, Joung H Lee

Abstract

Current literature on TSMs underemphasizes the significance of OCI by the tumor. In this study, we aimed to document the incidence of OCI, its management using a SBT, and its significance with relation to the visual outcome. Thirty-one patients with TSM were retrospectively analyzed. In 28 patients, SBT consisting of extradural anterior clinoidectomy with falciform ligament and optic nerve sheath opening was performed. Pre- and postoperative visual status was analyzed with respect to OCI. The incidences of OCI and preoperative visual deficit (VD) were 77.4% and 83.8%, respectively. With regard to preoperative visual status, OCI incidence was 84.6% in 26 patients with VD compared to 40% in 5 patients without (P = .016). Among the 23 patients with VD and detailed postoperative neuroopthalmologic evaluation, 78.3% had visual improvement; and in 21.7%, vision was unchanged on the operated side. In one patient (3.2% in the whole series), vision deteriorated on the side contralateral to the side of surgery. In the presence of OCI in 20 patients, vision improved in 80% and remained unchanged in 20%, whereas 1 of the 3 patients without OCI improved and the other 2 remained unchanged. Simpson grade I or II resection was achieved in 83.8...Continue Reading

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Citations

Nov 16, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Resha S SoniJames K Liu
Apr 1, 2014·Journal of Neurosurgery·Maria KoutourousiouPaul A Gardner
Sep 5, 2012·Acta neurochirurgica·Giuseppe MarinielloFrancesco Maiuri
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Apr 20, 2021·Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society·Yibing ZhangJonathan Trobe

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