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

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.

<p>Adamantinomatous Craniopharyngioma in an Adult: A Case Report with NGS Analysis</p>

“…Craniotomy was done by lateral supraorbital approach (LSO) for complete tumor excision. 26 After surgery, and before discharging from hospital, the patient was re-examined with MRI and CT scan. Results of re-examination revealed that the tumor was totally removed.…”

Tuberculum sellae meningioma: Is there an ideal approach?

“…Laterally we find the clinoid processes, the internal carotid and the posterior communicating arteries; posteriorly we identify the pituitary stalk, infundibulum, and the Lillequist membrane; superiorly, we have the optic chiasm, the lamina terminalis, and the anterior cerebral artery complex. 4 The space is quite small, (mean length 8mm, mean width 11mm), and the path of least resistance for tumor growth tends to be over the planum sphenoidale (anteriorly), the optic nerves into the optic canals (laterally), above the chiasma, displacing it superiorly, or down over the tuberculum and sellae (inferiorly) as shown in Figure 1. Table 1 shows the distribution of tumor size and levels of recovery of the 25 patients with visual impairment.…”

“…7 Several surgical approaches such as subfrontal, bifrontal, unilateral frontal, supraorbital keyhole, pterional have been proposed for the resection of TSM, and more recently the neurosurgical endoscopic techniques have been introduced as a visualization option during removal of skull base tumors, both transcranially and endonasally. 4 The aim of this paper is to report our case series, with special emphasis on different surgical approaches for TSM and their advantages and complications.…”

Dev Meninjiomalar: Bir Üniversite Hastanesinin 5 Yıllık Deneyimi

“…Chen ve ark. [17] ortalama 9,6 aylık takibi olan 6 vakalık serisinde total rezeksiyon %83,3, nüks %0, mortalite %16,6 olarak bildirilmektedir. Palani ve ark.…”