Clinical characteristics of tuberculum sellae meningiomas

Abstract

Objective To investigate the clinical and imaging features of tuberculum sellae meningioma (TSM) in order to improve the surgical effect. Methods The clinical data of 156 patients diagnosed with TSM who underwent microsurgery from January 2000 to December 2018 were analyzed retrospectively, including operation records, discharge records, follow-up records, preoperative visual acuity, visual field and postoperative improvement. According to the manifestations of CT and MRI, they were divided into giant, large, medium and small types, and the clinical and imaging features of TSM were analyzed and discussed. Results The most common symptom of TSM is asymmetric visual impairment. In this group, the preoperative visual acuity was less than 1.0, accounting for 96.8%, and asymmetric visual impairment accounted for 84.1%. 62.2% of the tumors invaded the optic canal. Before operation, the vision of 302 eyes was lower than 1.0, accounting for 96.8%. After operation, the vision of 218 eyes (69.87%) improved, 64 eyes (20.51%) maintained the preoperative level, and 30 eyes (9.62%) deteriorated. The images of 73 patients before operation indicated that the optic canal was involved (46.8%). During the operation, there were 97 cases of tumor invasion in the optic canal (62.2%). The image of 73 patients before operation showed that the optic canal was involved (46.8%), and there were 97 cases of tumor invasion in the optic canal (62.2%). The duration of clinical symptoms ranged from 1 month to 5.3 years (median 21 months). Postoperative vision improved in 218 eyes (69.87%), 64 eyes (20.51%) maintained preoperative level, and 30 eyes (9.62%) deteriorated. The patients were followed up from 3 months to 7.4 years. The degree of tumor resection was Simpson Ⅰ-Ⅱ in 145 cases, vision improved in 101 cases (69.66%), Simpson Ⅲ-Ⅳ in 11 cases, vision improved in 8 cases (72.73%). Conclusion Asymmetric visual dysfunction is the earliest and most common symptom of TSM. Tumors often involve the optic canal, which is the focus of preoperative evaluation of TSM. Key words: Tuberculum sellae meningioma; Microsurgery; Vision