Endoscopic Resection of Tuberculum Sellae Meningiomas

Gadgil, Nisha; Thomas, Jonathan G.; Yoshor, Daniel

doi:10.1055/s-0033-1342922

Cited by 27 publications

(22 citation statements)

References 50 publications

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“…In 11 non‐overlapping, retrospective, single‐institution series totaling 212 patients, GTR rates for suprasellar meningiomas approached via EEA ranged from 53.8% to 83.3% with a weighted average rate of GTR equaling 75.9% (Table ) …”

Section: Intradural Tumorsmentioning

confidence: 99%

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ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

152

279

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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Section: Intradural Tumorsmentioning

confidence: 99%

“…Among 170 patients included in 11 non‐overlapping, retrospective series, rates of vision improvement ranged from 33.3% to 91.7% following EEA for suprasellar meningioma resection with a weighted average rate of vision improvement of 77.6% (Table , ) . The largest EEA‐specific series averaged a rate of vision improvement of 85.7% .…”

Section: Intradural Tumorsmentioning

confidence: 99%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

152

279

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“…Prognosis is also better in younger patients with a short history of symptoms and good preoperative visual function. 3,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Regarding the surgical act, independently of technique, the initial debulking of the tumor should start from its center, where no vital structures are present. The arachnoid plane is then delineated, starting at the contralateral optic nerve and working toward the undersurface of the optic chiasma and then along the ipsilateral nerve.…”

Section: ■ Discussionmentioning

confidence: 99%

“…In cases of TSM with a significant level of optic nerve compromise and with limited lateral extensional, Gadget et al 22 have shown that an endoscopic endonasal resection is an excellent option.…”

Section: ■ Discussionmentioning

confidence: 99%

Tuberculum sellae meningioma: Is there an ideal approach?

Estevão¹,

Camporeze²,

Matricardi³

et al. 2017

Medical Express

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BACKGROUND:Tuberculum sellae meningiomas is a serious challenge for neurosurgeons. It accounts for up to 10% of all intracranial meningiomas. The difficulty in surgically excising a Tuberculum sellae meningioma comes from its anatomical relationship to the optic nerves and chiasm and to the anterior cerebral and internal carotid arteries and their perforators. The authors discuss the main approaches and the complications based on their experience in comparison to previously reported data. METHODS: We report our personal case series of 38 patients with Tuberculum sellae meningiomas; 36 patients under went craniotomy for tumor resection (12 bifrontal, 12 pterional, 6 supraciliary, 4 unilateral frontals, and 2fronto-orbito-zygomatic); in two patients, the excision was performed through an endoscopic endonasal approach. The Simpson grade of meningioma resection as well as the non-visual morbidity and the mortality rates were analyzed. RESULTS: Thirty-one patients had Simpson grades 1 and 2 excisions, while seven had Simpson grade 4 excisions. The overall rate of non-visual morbidity was 13.15% (5 of 38 patients) and mortality was 5.3% (2 of 38). CONCLUSION: The primary symptom leading to the diagnosis of a Tuberculum sellae meningioma is visual compromise and the main goal of surgery is to achieve improvement of vision. Favorable outcomes were achieved with appropriate selection of surgical approach. More studies are necessary to define the prognostic factors for patients in this scenario.

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“…Postoperative cerebrospinal fluid (CSF) leak and infection rates were high. Postoperative CSF leak was reported (respectively) in 30%e31% of olfactory groove and 14%e25.3% of TS meningiomas (10,12,15,16). Relatively high rates of pituitary insufficiency were reported in some endoscopic transnasal series: 14%e20% rate of permanent diabetes insipidus and up to a 7.7% rate of panhypopituitarism were observed (15).…”

Section: Morbidity and Mortalitymentioning

confidence: 99%