Visual Outcomes and Surgical Approach Selection Focusing on Active Optic Canal Decompression and Maximum Safe Resection for Suprasellar Meningiomas

Autor: Kiyohiko SAKATA, Satoru KOMAKI, Nobuyuki TAKESHIGE, Tetsuya NEGOTO, Jin KIKUCHI, Sosho KAJIWARA, Kimihiko ORITO, Hideo NAKAMURA, Masaru HIROHATA, Motohiro MORIOKA
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Neurologia Medico-Chirurgica, Vol 63, Iss 9, Pp 381-392 (2023)
Druh dokumentu: article
ISSN: 1349-8029
DOI: 10.2176/jns-nmc.2021-0142
Popis: The goal of treating patients with suprasellar meningioma is improving or preserving visual function while achieving long-term tumor control. We retrospectively examined patient and tumor characteristics and surgical and visual outcomes in 30 patients with a suprasellar meningioma who underwent resection via an endoscopic endonasal (15 patients), sub-frontal (8 patients), or anterior interhemispheric (7 patients) approach. Approach selection was based on the presence of optic canal invasion, vascular encasement, and tumor extension. Optic canal decompression and exploration were performed as key surgical procedures. Simpson grade 1 to 3 resection was achieved in 80% of cases. Among the 26 patients with pre-existing visual dysfunction, vision at discharge improved in 18 patients (69.2%), remained unchanged in six (23.1%), and deteriorated in two (7.7%). Further gradual visual recovery and/or maintenance of useful vision were also observed during follow-up. We propose an algorithm for selecting the appropriate surgical approach to a suprasellar meningioma based on preoperative radiologic tumor characteristics. The algorithm focuses on effective optic canal decompression and maximum safe resection, possibly contributing to favorable visual outcomes.
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