Lateral supraorbital approach applied to sellar tumors in 23 consecutive patients: the Suzhou experience from China.

Gang Chen,Zhong Wang,Dai Zhou

doi:10.1186/1477-7819-11-41

Abstract

BackgroundPituitary adenoma, craniopharyngioma and meningioma are common sellar lesions, accounting for more than 90% of sellar tumors. The aim of this study is to assess the reliability and safety of the lateral supraorbital (LSO) approach to remove sellar tumors.MethodsBetween June 2011 and December 2011, 23 patients with neoplastic lesions underwent surgery by the corresponding author (ZW) via the LSO approach. The clinical presentations, neuroradiological findings, microsurgical techniques, and outcome at discharge of these patients were analyzed. In addition, the clinical series in the available literature written in English were also extensively reviewed. Eleven (48%) patients were treated for pituitary adenoma; six (26%) patients for tuberculum sellae meningioma; and six (26%) patients for craniopharyngioma.ResultsSeemingly complete tumor removal was achieved in 21 patients (91%); surgical mortality was one patient (4.3%). Postoperatively, no patient had developed cerebrospinal fluid leakage or new visual deficits. One (4%) patient had intracranial infection, and one (4%) had a postoperative hematoma. The median Karnofsky score at discharge was 87.4 (range, 0 to 100). The Glasgow outcome scale at discharge was 4.6 (range, 1 to 5). Of all, 21 (91.3%) patients achieved favorable outcomes.ConclusionSellar tumors can be removed via the LSO approach with relatively low morbidity and mortality. Surgical results with this fast and simple approach are similar to those obtained with more extensive, complex, and time-consuming approaches.

Highlights

Pituitary adenoma, craniopharyngioma and meningioma are common sellar lesions, accounting for more than 90% of sellar tumors
Sellar tumors can be removed via the lateral supraorbital (LSO) approach with relatively low morbidity and mortality
Half of these occur in adults, they account for a greater percentage of childhood tumors (5 to 13%) and are responsible for 54% of sellar region pathology in children

Summary

Introduction

Craniopharyngioma and meningioma are common sellar lesions, accounting for more than 90% of sellar tumors. Craniopharyngiomas and tuberculum sellae meningioma, are by far the most common tumors of the sellar region, comprising 90% of all such tumors [1]. Meningiomas of the sellar region consist of approximately 14% of the intracranial total, occurring on the tuberculum sella or planum sphenoidale, on the medial sphenoid wing and cavernous. Half of these occur in adults, they account for a greater percentage of childhood tumors (5 to 13%) and are responsible for 54% of sellar region pathology in children. There are important differences in clinical presentation, pathology and outcome between children and adults [4]

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