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Acta Neurochirurgica
Published in: Acta Neurochirurgica 1/2011

01-01-2011 | Clinical Article

Extended endoscopic transphenoidal approach for tuberculum sellae meningiomas

Authors: Savas Ceylan, Kenan Koc, Ihsan Anık

Published in: Acta Neurochirurgica | Issue 1/2011

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Abstract

Purpose

Removal of tuberculum sella (TS) meningiomas is traditionally performed through transcranial approaches. Wide use of the endoscope in transphenoidal pituitary surgery is recently accessible through the tuberculum sellae with an endoscope-assisted or purely endoscopic technique. Extended endoscopic approach is an important and alternative route for meningiomas, which are located on the midline originating from the tuberculum sella. However, cerebrospinal fluid (CSF) leakage is an important problem in extended endoscopic approaches. In this report, we discuss surgical limitations and nuances of endoscopic transphenoidal approach from a retrospective analysis of nine patients with TS meningiomas.

Methods

Endoscopic transphenoidal approach was performed for seven women and two men (mean age, 51.1 years; age range, 32–78 years) with TS meningiomas between July 2007 and March 2010 in the Department of Neurosurgery, Kocaeli, Turkey.

Results

Total removal was achieved in six of nine patients. An improvement of the preoperative visual deficits was observed in six of the nine patients. Multilayer closure was performed for reconstruction, and lumbar external drainage was used for all patients for 3–5 days. CSF leakage was not seen in any of the patients after the operation and removal of the drainage.

Conclusion

Endoscopic extended transphenoidal approach is still not a standardized procedure for TS meningiomas, but it may be considered as an alternative procedure in selected cases.
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Metadata
Title
Extended endoscopic transphenoidal approach for tuberculum sellae meningiomas
Authors
Savas Ceylan
Kenan Koc
Ihsan Anık
Publication date
01-01-2011
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 1/2011
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-010-0788-1

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