Microsurgical Resection of Tuberculum Sellae Meningioma through Pterional Approach with Extradural Optic Canal Unroofing
| Autor: | Yuichiro Miyamatsu, Satoshi Matsuo, Akira Nakamizo, Sojiro Yamashita, Toshiyuki Amano |
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| Rok vydání: | 2020 |
| Předmět: |
Pituitary stalk
medicine.medical_specialty Visual acuity genetic structures Optic canal business.industry Neurovascular bundle medicine.disease nervous system diseases Meningioma Tuberculum Sellae Meningioma medicine.anatomical_structure medicine.artery otorhinolaryngologic diseases medicine Tuberculum sellae Neurology (clinical) Radiology Internal carotid artery medicine.symptom business |
| Zdroj: | Journal of neurological surgery. Part B, Skull base. 83(Suppl 3) |
| ISSN: | 2193-6331 |
| Popis: | Tuberculum sellae meningiomas pose significant challenges because they are surrounded by crucial neurovascular structures, such as the optic and oculomotor nerves, pituitary stalk, internal carotid artery and its branches, and the anterior cerebral arteries. Even if small, such meningiomas frequently extend to the optic canal that is considered a poor prognostic factor for vision. In this video clip, we illustrate the case of a 60-year-old female who had an approximately 3-cm tuberculum sellae meningioma with optic canal involvement. She underwent surgical resection of the tumor through a pterional approach. After extradural optic canal unroofing, detaching, devascularizing, and debulking the tumor, careful dissection of the meningioma from the surrounding tissues was performed. Next, the tumor extensions into both of the optic canals were removed. Finally, coagulation and resection of the tumor origin on the dura of the tuberculum sellae following Simpson's grade-I resection were performed. Histopathology revealed that the tumor was a World Health Organization (WHO) grade-I meningioma. The patient had an uneventful postoperative course and her visual acuity was preserved, with no visual field defect on postoperative visual examination. In this video, the basic surgical techniques in performing extradural optic canal unroofing, preserving the arachnoid plane, and stay in collect layer, which is the essential technique for dissecting meningiomas and for preserving neurovascular structures, are demonstrated.The link to the video can be found at: https://youtu.be/vD54Iji0C4Q. |
| Databáze: | OpenAIRE |
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