Особливості хірургічних втручань при менінгіомах навколоселярної локалізації

Abstract

Objective — to improve surgical tactics in patients with around-sellar meningiomas (ASM) and removal of these tumors.Materials and methods. The features of surgical treatment of 137 patients with ASM were stu-died. Male population was 40 (29.2 %), female — 97 (70.8 %). The average age was (51.8 ± 0.9) years. Selection criteria: meningiomas of the Turkish sella, the small wing of the sphenoid bone and the anterior clinoidal process, the medial parts of the large wing of the sphenoid bone and the lateral wall of the cavernous sinus. When choosing an approach, the size of the tumor, the localization and the relationship with the surrounding neural structures were taken into account.Results. The results of the treatment of ASM were satisfactory. Total removal was achieved in 57 (41.6 %) patients, subtotal — in 77 (56.2 %), partial — in 3 (2,2 %). In 93 patients (67.9 %) with the spread of ASM in the optic canal, bone decompression was performed. The function of the optic nerve improved in 38 (27.7 %) patients. The Karnofsky score of 70 points and below before the operation was recorded in 27 (19.7 %) patients, after surgery — in 11 (8.0 %), 80 points and above — respectively 110 (80.3 %) and 126 (92.0 %).Conclusions. The key to a successful surgical intervention under ASM is the adequate surgical approach. The choice of approach is influenced by the topography of tumors, size and direction of growth. The spreading ASM to the optic nerve canаl requires the bone decompression of the optic nerve.