Identification and protection strategy of pituitary stalk during microsurgery of sellar region tumors

Abstract

Objective To study the protection strategy of pituitary stalk via transcranial approach for sellar tumors resection.Methods Retrospective analysis of the clinical data of 110 patients with sellar region tumors was performed.Craniotomy was performed via the pterional approach in 34 cases,the subfrontal approach in 21 cases,the supraorbital keyhole approach in 20 cases,the interhemispheric approach in 35 cases (the fronto-basal interhemispheric approach in 26 patients,and the anterior interhemispheric approach through the lamina terminalis in 9 patients).Results In 47 cases with pituitary adenoma,the tumors were totally resection in 42 cases,the pituitary stalks were preserved in 44 cases,partly retained in 2 and not founded in 1.In 38 cases with craniopharyngioma,the tumors were totally removed in 32 cases.The pituitary stalks were preserved in 27 cases,and partly retained in 7 cases and not founded in 4.In 25 patients with Meningioma,the tumors were totally removed in 23 cases,the pituitary stalks were preserved in 24 cases (P ＜ 0.05).Conclusions The nature of tumors directly affect the retention rate of pituitary stalk,so we should choose appropriate surgical approach and skilled microsurgical techniques which play an important role in the identification and protection of pituitary stalk. Key words: Pituitary stalk ; Sellar region tumor ; Craniotomy; Microsurgery