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tuberculum sellae

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https://www.readbyqxmd.com/read/29775151/selection-of-endoscopic-or-transcranial-surgery-for-tuberculum-sellae-meningiomas-according-to-specific-anatomical-features-a-retrospective-multicenter-analysis-kosen-002
#1
Doo-Sik Kong, Chang-Ki Hong, Sang Duk Hong, Do-Hyun Nam, Jung-Il Lee, Ho Jun Seol, Jiwoong Oh, Dong Gyu Kim, Yong Hwy Kim
OBJECTIVE The endoscopic endonasal approach (EEA) and the transcranial approach (TCA) are good options for the treatment of tuberculum sellae (TS) meningiomas. The objective of this study was to identify the key anatomical features in TS meningiomas and compare the two surgical approaches. METHODS The authors retrospectively reviewed clinical data in 178 patients with TS meningiomas treated at 3 institutions between January 2010 and July 2016. Patients with tumors encasing the internal carotid artery or anterior cerebral artery or involving the anterior clinoid process or cavernous sinus were excluded...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29770286/resection-of-an-optic-canal-meningioma-through-a-contralateral-subfrontal-approach-with-endoscopic-assistance-a-2d-operative-video
#2
Moujahed Labidi, Kentaro Watanabe, Anne-Laure Bernat, Shunya Hanakita, Sébastien Froelich
Objective  To review the use of the contralateral subfrontal approach for the resection of an optic canal meningioma. Design  Operative video. Results  A meningioma, located in the inferomedial side of the optic canal ( Fig. 1 ), was found to cause significant visual deterioration. The subfrontal route was preferred to expose the tumor without mobilization of the optic nerve. Drilling of the anterior limb of the chiasmatic sulcus (limbus sphenoidale) provided adequate exposure of the medial aspect of the optic canal...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29726777/surgical-outcomes-after-reoperation-for-recurrent-skull-base-meningiomas
#3
Stephen T Magill, David S Lee, Adam J Yen, Calixto-Hope G Lucas, David R Raleigh, Manish K Aghi, Philip V Theodosopoulos, Michael W McDermott
OBJECTIVE Skull base meningiomas are surgically challenging tumors due to the intricate skull base anatomy and the proximity of cranial nerves and critical cerebral vasculature. Many studies have reported outcomes after primary resection of skull base meningiomas; however, little is known about outcomes after reoperation for recurrent skull base meningiomas. Since reoperation is one treatment option for patients with recurrent meningioma, the authors sought to define the risk profile for reoperation of skull base meningiomas...
May 4, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29702946/virtual-line-between-anterior-clinoid-process-and-tuberculum-sellae-on-3-dimensional-computed-tomography-angiography-to-differentiate-cavernous-sinus-aneurysms-from-intradural-aneurysms
#4
https://www.readbyqxmd.com/read/29606045/tuberculum-sellae-meningiomas-grading-scale-to-assess-surgical-outcomes-using-the-transcranial-versus-transsphenoidal-approach
#5
Stephen T Magill, Ramin A Morshed, Calixto-Hope G Lucas, Manish K Aghi, Philip V Theodosopoulos, Mitchel S Berger, Oreste de Divitiis, Domenico Solari, Paolo Cappabianca, Luigi M Cavallo, Michael W McDermott
OBJECTIVE Tuberculum sellae meningiomas (TSMs) are surgically challenging tumors that can severely impair vision. Debate exists regarding whether the transcranial (TC) or endoscopic transsphenoidal (TS) approach is best for resecting these tumors, and there are few large series comparing these approaches. METHODS A retrospective chart review was performed at 2 academic centers comparing TC and TS approaches with respect to vision, extent of resection, recurrence, and complications. The authors report surgical outcomes and propose a simple preoperative tumor grading scale that scores tumor size (1-2), optic canal invasion (0-2), and arterial encasement (0-2)...
April 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29606040/decision-making-algorithm-for-minimally-invasive-approaches-to-anterior-skull-base-meningiomas
#6
Malte Ottenhausen, Kavelin Rumalla, Andrew F Alalade, Prakash Nair, Emanuele La Corte, Iyan Younus, Jonathan A Forbes, Atef Ben Nsir, Matei A Banu, Apostolos John Tsiouris, Theodore H Schwartz
OBJECTIVE Anterior skull base meningiomas are benign lesions that cause neurological symptoms through mass effect on adjacent neurovascular structures. While traditional transcranial approaches have proven to be effective at removing these tumors, minimally invasive approaches that involve using an endoscope offer the possibility of reducing brain and nerve retraction, minimizing incision size, and speeding patient recovery; however, appropriate case selection and results in large series are lacking. METHODS The authors developed an algorithm for selecting a supraorbital keyhole minicraniotomy (SKM) for olfactory groove meningiomas or an expanded endoscopic endonasal approach (EEA) for tuberculum sella (TS) or planum sphenoidale (PS) meningiomas based on the presence or absence of olfaction and the anatomical extent of the tumor...
April 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29588905/endoscopic-endonasal-resection-of-a-suprasellar-pituitary-adenoma-mimicking-tuberculum-sellae-meningioma-in-a-patient-with-an-intrasellar-persistent-trigeminal-artery
#7
Alaa S Montaser, Alexandre B Todeschini, Juan M Revuelta Barbero, Mostafa Shahein, E Antonio Chiocca, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
A 50-year-old female with an incidentally diagnosed suprasellar lesion was initially managed conservatively due to the presence of an intrasellar persistent trigeminal artery going through the dorsum sellae and fundamentally forming the blood supply of the entire posterior circulation. Serial follow-up brain magnetic resonance imaging (MRI) revealed progressive enlargement of the suprasellar lesion over 4 years period. Surgery was indicated after the initial tumor growth; however, the patient refused surgery for fear of complications related to the persistent trigeminal artery...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588896/endoscopic-endonasal-resection-of-tuberculum-sellae-meningioma-with-utilization-of-indocyanine-green
#8
Mostafa Shahein, Alaa S Montaser, Alexandre B Todeschini, Juan M Revuelta Barbero, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
We present the case of a 67-year-old female with an incidental finding of a left-sided tuberculum sellae meningioma on a brain magnetic resonance imaging (MRI) for an unrelated complaint. Formal visual field testing showed a small defect in the inferior nasal and temporal fields of the left eye, compatible with mass effect on the optic nerve by the tumor. An endoscopic endonasal transtuberculum approach with decompression of the left optic nerve was performed using a standard binostril four-hand technique, with the patient positioned supine with the head turned to the right side and tilted to the left, fixed in a three-pin head clamp, under imaging guidance...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588895/expanded-endoscopic-transsphenoidal-resection-of-tuberculum-sella-meningioma-invading-the-optic-canal
#9
Georgios Klironomos, Margherita Bruni, Amir R Dehdashti
A 61-year-old male patient presented with recurrent malignant meningioma involving the left optic canal and decreased vision from the left eye. The patient had undergone orbital exenteration on the right 2 years ago. The decision to treat the patient was made based on the significant vision deterioration and rapid tumor growth. Endoscopic transsphenoidal approach considered the most suitable route due to the inferomedial invasion of the optic canal. Gross total removal was achieved and the patient's vision improved postoperatively...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588894/surgery-of-tuberculum-sellae-meningioma-a-technical-purview-on-pterional-approach
#10
Anil Nanda, Devi Prasad Patra, Amey Rajan Savardekar, Nasser Mohammed, Vinayak Narayan, Shyamal C Bir
Objective  Amidst the raging debate between transnasal and transcranial approaches, the critical factor that dictates success lies in the meticulous dissection of the tumor from the optic apparatus, anterior communicating artery complex, and the pituitary stalk. In this surgical video, we describe the resection of a tuberculum sellae meningioma through the pterional approach highlighting dissection through the appropriate arachnoidal plane. Case Description  The patient is a 75-year-old female who presented with optic nerve compression with bitemporal hemianopia and endocrine function abnormalities...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588893/lateral-supraorbital-craniotomy-for-tuberculum-sella-meningioma-resection
#11
Georgios Klironomos, Neal Mehan, Amir R Dehdashti
Tuberculum sella meningioma can be approached by either open or endoscopic approaches. The aim of this video case presentation is to highlight the nuances of the lateral supraorbital craniotomy for tuberculum sella meningioma resection. The authors present a 34-year-old female patient who presented with decreased right eye visual acuity (20/60), afferent pupillary defect, and nasal field cut due to a tuberculum sella meningioma. The tumor was partially encasing the left A1 artery, severely displacing the optic apparatus, and minimally invading the right optic canal...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588892/orbitopterional-approach-with-extradural-clinoidectomy-for-the-resection-of-a-tuberculum-sellae-meningioma-adapting-the-strategy-to-the-microsurgical-and-pathological-anatomy
#12
Jaafar Basma, Vincent Nguyen, Jeffrey Sorenson, L Madison Michael
Objectives  To describe the orbitopterional approach with extradural clinoidectomy for the resection of a tuberculum sellae meningioma, with an emphasis on the microsurgical and pathological anatomy of such lesions. Design  After completing the orbitopterional craniotomy in one piece, the optic nerve is identified extradurally, unroofed, and the clinoid process resected. The falciform ligament is divided and the optic nerve is decompressed extradurally. Opening the frontotemporal dura exposes the tumor in the subfrontal region...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29524704/endoscopic-endonasal-surgery-treatment-strategies-for-invasive-pituitary-adenoma-analysis-of-four-approaches
#13
Yang Ji-Hu, Huang Guo-Dong, Ji Tao, Wang Hai-Dong, Liu Yu-Fei, Guo Jian, Li Zhen, Li Wei-Ping
OBJECTIVE: To explore the surgical methods and clinical effect of endoscopic endonasal approaches for the treatment of invasive pituitary adenomas(IPA). METHODS: A retrospective analysis of the clinical data of 74 patients(75 procedures) with invasive pituitary adenomas treated by different endoscopic endonasal approaches at the Department of Neurosurgery, the First Affiliated Hospital of Shenzhen University from May 2014 to August 2017. The data include clinical manifestation, imaging features, surgical methods and complications, resection rate, cure rate, prognosis and complications in different Knosp classifications and Hardy stages...
March 7, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29495222/-the-curative-effect-analysis-of-unilateral-subfrontal-combined-with-interhemispheric-approach-on-the-microsurgery-of-large-anterior-skull-base-meningioma
#14
X L Zheng, Z Q Jiang, Y Han, T Sun, T Zhang, S J Zhang, F Y Lou
Objective: To explore the surgical technique and curative effect of microsurgical resection of large anterior skull base meningioma via unilateral subfrontal and interhemispheric approach. Method: The clinical data of 14 patients with large anterior skull base meningioma who received surgical treatment in the Department of neurosurgery in First Affiliated Hospital of Bengbu Medical College from April 2015 to September 2017 were analysed retrospectively.Of 9 cases were olfactory groove meningioma and 5 cases were tuberculum sellae meningioma...
February 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29432945/utility-of-3-dimensional-printed-models-in-enhancing-the-learning-curve-of-surgery-of-tuberculum-sellae-meningioma
#15
Qing-Song Lin, Yuan-Xiang Lin, Xi-Yue Wu, Pei-Sen Yao, Ping Chen, De-Zhi Kang
OBJECTIVE: To investigate the value of 3-dimensional (3D)-printed models with pathologic entities in enhancing the learning curve of surgery of tuberculum sellae meningioma. METHODS: We printed 4 models of tuberculum sellae meningiomas based on radiologic data using a 3D printer. Participants were allocated to the 3D group and the atlas group. In the 3D group, participants learned surgery with the assistance of 3D models. In the atlas group, participants used only 2-dimensional materials to assist their learning...
May 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29404262/tuberculum-sellae-meningioma-resection-technical-nuances-on-the-frontopterional-approach
#16
Oriela Rustemi, Renato Scienza, Alessandro Della Puppa
Tuberculum sellae meningioma remains a surgical challenge. Deep location of tumor, vascular and nerve encasement, and pituitary stalk involvement are the main technical issues. The frontopterional approach represents a natural, simple, and elegant approach to this area enabling surgeon to have a direct control on all anatomical structures. A 42-year-old woman was referred with a delayed diagnosis of tuberculum sellae meningioma due to the presence of HLA-B27-associated uveitis. She presented with 1/10 visual acuity in the left eye and no right visual function...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29404261/microsurgical-resection-of-tuberculum-sellae-meningioma-through-left-cranio-orbital-approach
#17
Mirza Pojskić, Kenan I Arnautović
In this video clip, the authors present the resection of a tuberculum sellae meningioma with compression of the left optic nerve and a chiasm ( Fig. 1 ) through a standard cranial orbital (CO) skull base approach. 1 2 3 The key step in the tumor resection was microsurgical dissection of left and right A1 segments of the anterior cerebral artery and the anterior communicating artery and the separation of the tumor from these vascular structures. This was followed by careful separation of the meningioma from both optic nerves, the chiasm and the pituitary stalk...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29404260/microsurgical-resection-of-lateral-tuberculum-sellae-meningioma-operative-video
#18
Duarte N C Cândido, Paulo E H Nakashima, Jean Gonçalves de Oliveira, Luis A B Borba
Tuberculum Sellae Meningiomas (TSMs) are lesions dramatically related to the optic apparatus once the principal clinical complain remains on visual alterations. This is the main picture on decision making to evaluate the best time, risk-benefit, and surgical approaches to the patient treatment. In this video, we present a 65 years old female with 30 days complaint of unilateral (right) complete blindness and complete impaired right eye field test. On physical examination, there were normal pupillary function to light tests...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29404259/tuberculum-meningioma-orbitopterional-approach
#19
Alexander Yang, Mohammed Aref, A Samy Youssef
This is a case of an extensive tuberculum sella meningioma involving the circle of Willis down to the basilar artery that presented with bilateral visual loss worse on the right than left side. A one-piece right orbitopterional approach along the worse eye was used to gain access to the three cranial fossae. The orbitotomy facilitates access to the midline structures and contralateral base of the tumor with minimal brain retraction. Tumor resection is initiated by first identifying the tumor capsule, followed by piecemeal debulking via ultrasonic aspiration...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29404258/microsurgical-resection-of-tuberculum-sellae-meningioma-via-pterional-craniotomy-with-extradural-anterior-clinoidectomy-and-optic-unroofing
#20
Ihsan Dogan, Melih Ucer, Mustafa Kemal Başkaya
Microsurgical treatment of suprasellar tumors, in particular tuberculum sellae meningiomas, poses significant challenge. These tumors are surrounded by vital neurovascular structures, such as optic apparatus, pituitary stalk, internal carotid artery and its branches, and anterior cerebral arteries. In large and complex cases, early identification and decompression of these structures may facilitate safer dissection and resection. Therefore, extradural anterior clinoidectomy with optic unroofing facilitates the internal carotid artery exposure and optic nerve decompression...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
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