Selection of endoscopic or transcranial surgery for tuberculum sellae meningiomas according to specific anatomical features: a retrospective multicenter analysis (KOSEN-002)

Journal of Neurosurgery
Doo-Sik KongYong Hwy Kim

Abstract

The endoscopic endonasal approach (EEA) and the transcranial approach (TCA) are good options for the treatment of tuberculum sellae (TS) meningiomas. The objective of this study was to identify the key anatomical features in TS meningiomas and compare the two surgical approaches. The authors retrospectively reviewed clinical data in 178 patients with TS meningiomas treated at 3 institutions between January 2010 and July 2016. Patients with tumors encasing the internal carotid artery or anterior cerebral artery or involving the anterior clinoid process or cavernous sinus were excluded. Tumors were classified as high-lying or low-lying based on their location, and involvement of the optic canal was evaluated. The surgical outcomes of EEA and TCA were analyzed according to the relevant anatomical features. During the study period, 84 patients underwent EEA and 94 patients underwent TCA. Based on preoperative MR images, 43 (24.2%) meningiomas were classified as high-lying tumors, 126 (70.8%) as low-lying, and 9 (5.0%) as nonspecific. Gross-total resection (GTR) was performed in 145 patients (81.5%); the GTR rate did not differ significantly between the EEA and TCA groups. Of 157 patients with preoperative visual disturbance, 140 ha...Continue Reading

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Citations

Dec 14, 2019·Acta neurochirurgica·Lorenzo GiammatteiRoy T Daniel
Jul 11, 2020·Operative Neurosurgery·Etienne LefevreDorian Chauvet
Mar 1, 2021·Journal of Neurological Surgery. Part A, Central European Neurosurgery·Pier Paolo MattognoAlessio Albanese
Mar 30, 2021·Journal of Neurological Surgery. Part B, Skull Base·Elizabeth L Echalier, Prem S Subramanian

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