Surgical treatment of tumors in sellar region through transbasal interhemispheric approach

Abstract

Objective To explore the surgical therapeutic efficacy of tumors in sellar region through transbasal interhemispheric approach. Method Fifteen sellar region tumor cases was treated through transbasal interhemispheric approach from January 2008 to May 2009. These cases included four craniopharyngiomas, four tuberculum sellae meningiomas, three olfactory grave meningiomas, two nofunction pituitary adenomas,one stalk hypophysial abscess and one frontal lobe glioma. The first symptom of ten cases was disturbance of vision or field of vision,four headace,one insipidus. All the fifteen cases underwent head MRI before and after operation. The diameter of the biggest tumor was 5 cm. All the tumors located around sellar region and grew upward. Result Total resection was achieved in all cases. Hyperosmotc dehydration was observed in 3 patients after operation. One craniopharyngioma patient died after leaving hospital because of electrolyte disturbance. Two craniopharyngioma patients leaved hospital normally after the electrolyte disturbance had been corrected. The original symptoms of rest cases were relieved and there was no nervous dysfunction. One craniopharyngioma patient received Gamma knife radiosurgery after operation because of tumor recurrence. There was no recurrence in the rest cases. There was no intracranial infection or cerebrospinal fluid rhinorrhea. The facial outlook wasn't affected. Conclusions Transbasal interhemispheric approach could provide much more surgical visible angle. Through this approach the third ventricle chould be reached ,the midbrain aqueduct chould be revealed backward and sellar region downward and better outcome of surgery chould be achieved. Key words: Sellar region; Tumor; Neurosurgical procedures; Transhasal interhemispheric approach