Neuroendoscopy
Efficacy evaluation of neuroendoscopic extended transnasal approach for resection of tuberculum sella meningiomas
Ma Guofo, Li Chuzhong, Bai Jiwei, Zhao Peng, Cao Lei, Wang Xinsheng, Zhang Yazhuo, Gui Songbai
Published 2022-02-28
Cite as Chin J Neurosurg, 2022, 38(2): 113-116. DOI: 10.3760/cma.j.cn112050-20210807-00389
Abstract
ObjectiveTo investigate the clinical effect of neuroendoscopic extended transnasal approach for resection of tuberculum sella meningiomas (TSMs).
MethodsA retrospective analysis was conducted on the clinical data of 39 patients with TSMs resected through neuroendoscopic extended transnasal approach in the Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University from October 2018 to December 2020. On the 1st postoperative day, the patient′s endocrine function was rechecked; on the 7th postoperative day, the enhanced head MRI and ophthalmological examinations were reperformed. All patients were followed up at outpatient clinics. The content of the follow-up included re-examination of the head MRI to determine the recurrence of tumors, ophthalmological re-examination to determine the improvement of the patient′s vision and visual field and endocrine function re-examination to determine the the recovery of the patients with endocrine.
ResultsThe operations of 39 patients were all successful. Among them, 1 case (2.6%) had cerebrospinal fluid leakage, 1 case (2.6%) had central nervous system infection and they healed after aggressive treatment; none died or developed coma. The endocrine function results at 1 day after operation showed that 5 patients (12.8%) had transient hypocortisolism. Re-examination of head MRI 7 days after operation showed that Simpson grade Ⅰ resection was achieved in 37 patients (94.9%) and grade Ⅱ resection in the other 2 cases (5.1%). There were 33 patients with impaired vision and visual field before operation, 31 cases(93.9%) improved after operation, and 2 cases (6.1%) did not improve. The median follow-up time of 39 patients was 17 months (6-32 months). During the follow-up period, none of the patients had tumor recurrence, and the results of the ophthalmological re-examination remained the same to postoperative conditions, 5 patients with decreased cortisol levels, they returned to normal 3 months or 6 months after surgery.
ConclusionThe postoperative complication rate of neuroendoscopic extended transnasal resection of TSMs is low, and most patients with visual acuity and visual field defects can be improved after surgery.
Key words:
Meningioma; Natural orifice endoscopic surgery; Treatment outcome; Tubercle sellae
Contributor Information
Ma Guofo
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Ma Guofo is working at the Department of Neurosurgery, Peking University Third Hospital, Beijing 100191, China
Li Chuzhong
Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
Bai Jiwei
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Zhao Peng
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Cao Lei
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Wang Xinsheng
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Zhang Yazhuo
Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
Gui Songbai
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
