Surgical resection of tuberculum sellae meningiomas through lateral supraorbital approach: A report of 34 cases

Abstract

Objective To assess the reliability and safety of lateral supraorbital (LSO) approach in the surgical treatment of tuberculum sellae meningiomas (TSMs). Methods A total of 34 patients underwent operation through LSO approach between June 2013 and June 2017 at Department of Neurosurgery at Qilu Hospital of Shandong University and their clinical data were retrospectively analyzed in this study. All patients underwent surgical resection of the tumor via LSO approach. The extent of resection of the tumor was assessed using the Simpson classification. The effectiveness of the procedure was evaluated based on the patient's postoperative MRI and improvement in neurological symptoms, and the safety of the procedure was assessed based on the occurrence of postoperative complications. Results All patients were followed up for 3-36 months with an average of 12±5 months. Of the 34 patients, 30 underwent Simpson Ⅰ-Ⅱ resection and 4 received Simpson Ⅲ resection. Postoperative visual acuity was improved in 23 cases, no change was reported in 8 cases, and visual impairment was worse than preoperative conditions in 3 cases. There were 3 cases of postoperative fever, 3 cases of hyponatremia, 1 case of psychiatric symptoms, 1 case of cerebral edema, and 2 cases of epileptic seizures. In 1 (3%) patient, postoperative imaging findings confirmed recurrence. Conclusions LSO approach has multiple advantages including simplified and fast skull opening and closing, clean operative field and small trauma, and it could be used in the effective treatment of TSMs. Key words: Meningioma; Microsurgery; Treatment outcome; Lateral supraorbital approach; Tuberculum sellae