Download PDF
CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(01): 22-25
DOI: 10.4103/ajns.AJNS_85_19
Original Article

Endoscopic endonasal transsphenoidal approach for resection of tuberculum sella and planum sphenoidale meningiomas: A snapshot of our institutional experience

Md Salek
1   Department of Neurosurgery, Combined Military Hospital, Dhaka
,
Md Faisal
1   Department of Neurosurgery, Combined Military Hospital, Dhaka
,
Md Manik
1   Department of Neurosurgery, Combined Military Hospital, Dhaka
,
Ahmed-Ul-Mursalin Choudhury
1   Department of Neurosurgery, Combined Military Hospital, Dhaka
,
Rukun Chowdhury
1   Department of Neurosurgery, Combined Military Hospital, Dhaka
,
Md Islam
1   Department of Neurosurgery, Combined Military Hospital, Dhaka
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Introduction: Meningiomas of the tuberculum sellae and planum sphenoidale represent a subgroup of anterior skull base tumors that comprise approximately 5%–10% of all intracranial meningiomas. Most of the patients report with failing vision, so early surgical decompression either transcranial and/or endonasal approach is recommended. The endonasal route allows for direct coagulation of the tumor meningeal supply and extensive resection of dural attachments, and importantly, provides an inferior to superior access to the infrachiasmatic region that facilitates complete tumor removal without encountering the optic nerve. This article describes our institutional experience for the endonasal resection of tuberculum sellae and planum sphenoidale meningiomas. Materials and Methods: We retrospectively analyzed eight cases of tuberculum sellae and planum sphenoidale meningiomas who selectively underwent endoscopic endonasal transsphenoidal resection between 2015 and 2018. All patients had ophthalmological, endocrinological, and radiological evaluation both preoperatively and postoperatively. Results: Among the study group, we found age range 22–68 years, male:female 1:2. Among the radiological findings, there were five cases of tuberculum sellae meningioma, while three cases were of planum sphenoidale meningioma. In tumor resection status, we found gross total resection in six cases and debulking in two cases. Postoperative analysis of visual outcome revealed improvement in four cases, constant in three cases, and worsening in one case. We also found the post of nasal complications in four cases, cerebrospinal fluid leak in two cases and transient diabetes insipidus in one case. Conclusion: In this study, we highlighted our experience of a very small group of patients with anterior fossa meningioma specific to tuberculum sella and planum sphenoidale origin.

Key-words:

Endoscopic endonasal approach introduction - planum sphenoidale - tuberculum sellae

Financial support and sponsorship

Nil.




Publication History

Received: 04 April 2019

Accepted: 19 June 2019

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Chi JH, McDermott MW. Tuberculum sellae meningiomas. Neurosurg Focus 2003;14:e6.
  • 2 Fernandez-Miranda JC, Pinheiro-Nieto C, Gardner PA, Snyderman CH. Endoscopic endonasal approach for a tuberculum sellae meningioma. J Neurosurg 2012;32 Suppl: E8.
  • 3 Fahlbusch R, Schott W. Pterional surgery of meningiomas of the tuberculum sellae and planum sphenoidale: Surgical results with special consideration of ophthalmological and endocrinological outcomes. J Neurosurg 2002;96:235-43.
  • 4 Jallo GI, Benjamin V. Tuberculum sellae meningiomas: Microsurgical anatomy and surgical technique. Neurosurgery 2002;51:1432-39.
  • 5 Di Somma A, Torales J, Cavallo LM, Pineda J, Solari D, Gerardi RM, et al. Defining the lateral limits of the endoscopic endonasal transtuberculum transplanum approach: Anatomical study with pertinent quantitative analysis. J Neurosurg 2018;130:848-6.
  • 6 Fatemi N, Dusick JR, de Paiva Neto MA, Malkasian D, Kelly DF. Endonasal versus supraorbital keyhole removal of craniopharyngiomas and tuberculum sellae meningiomas. Neurosurgery 2009;64:269-84.
  • 7 Bander ED, Singh H, Ogilvie CB, Cusic RC, Pisapia DJ, Tsiouris AJ, et al. Endoscopic endonasal versus transcranial approach to tuberculum sellae and planum sphenoidale meningiomas in a similar cohort of patients. J Neurosurg 2018;128:40-8.
  • 8 Kitano M, Taneda M, Nakao Y. Postoperative improvement in visual function in patients with tuberculum sellae meningiomas: Results of the extended transsphenoidal and transcranial approaches. J Neurosurg 2007;107:337-46.
  • 9 López F, Suárez V, Costales M, Rodrigo JP, Suárez C, Llorente JL. Endoscopic endonasal approach for the treatment of anterior skull base tumours. Acta Otorrinolaringol Esp 2012;63:339-47.
  • 10 Ottenhausen M, Banu MA, Placantonakis DG, Tsiouris AJ, Khan OH, Anand VK, et al. Endoscopic endonasal resection of suprasellar meningiomas: The importance of case selection and experience in determining extent of resection, visual improvement, and complications. World Neurosurg 2014;82:442-9.