Neurosurgery Blog

Icon

Daily bibliographic review of the Neurosurgery Department. La Fe University Hospital. Valencia, Spain

Clinical outcomes of tuberculum sellae meningiomas focusing on reversibility of postoperative visual function

Tuberculum Sellae Meningiomas

Acta Neurochir (2013) 155:25–31

Tuberculum sellae meningiomas present a special challenge because of their proximity to major arteries, visual pathways, and the hypothalamus. The aim of this study was to determine the prognostic determinants of clinical and visual outcomes of these tumors, focusing on the functional reversibility of an unserviceable eye after surgery.

Methods We retrospectively reviewed 86 patients on the basis of clinical and radiological factors that appeared to affect outcome. The visual acuity and visual fields were analyzed according to the visual impairment score (VIS). Unserviceable visual acuity included no perception of light (NPL), hand movement (HM), and counting fingers (CF). Ophthalmological functioning was tested in the preoperative period, the postoperative short-term period (≤2 weeks after surgery), and the postoperative long-term period (>6 months after surgery). Our own clinical outcome criteria including tumor control, visual improvement, and complications were used for evaluation.

Results Seventy-four of 86 patients (86 %) underwent total removal of the tumor. In three of these cases (3.4 %), recurrence developed. Thirty patients were classified into the “Excellent” group, 21 into the “Good” group, 20 into the “Fair” group, and 15 into the “Poor” group. In multivariate analysis, adhesion to optic nerve was an independent and significant predictor of clinical outcome. Favorable visual outcomes in both short- and long-term postoperative periods were achieved in 80.8%of cases. Preoperative and short-term visual outcomes were closely related to long-term visual outcome. Six of eight patients with preoperative CF status showed reversibility to a serviceable status after surgery. However, there was no conversion to serviceable status from NPL or HM.

Conclusions For patients with unilateral unserviceable visual function, maintenance of serviceable visual function on the opposite side might be more important. Of the patients with unserviceable visual function, careful surgery might be able to improve the visual function in CF eyes.

Category: Oncology, Outcome

Tagged: , , , ,

Comments are closed.

The Safety and Feasibility of Image-Guided BrainPath-Mediated Trans-Sulcal Hematoma Evacuation

Haptic Virtual Reality Aneurysm Clipping

Subtemporal Approach for AICA Aneurysm Clipping

MCA Aneurysm Anatomical Classification Scheme

Blister Aneurysms of the Internal Carotid Artery

Bypass for Complex Basilar Aneurysms

Basilar Invagination and Atlanto-Axial Dislocation Video 1

Indocyanine Green Videoangiography “In Negative” Video 2

Indocyanine Green Videoangiography “In Negative” Video 1

Management of a Recurrent Coiled Giant Posterior Cerebral Artery Aneurysm

Bypass for Complex Basilar Aneurysms

Expanded Endonasal Approach for 2012 MERC

Endoscopic Endonasal Middle Clinoidectomy Video 1

Endoscopic Endonasal Middle Clinoidectomy Video 2

Neurosurgery CNS: Flash Fluorescence for MCA Bypass Video 2

Neurosurgery CNS: Flash Fluorescence for MCA Bypass Video 1

Neurosurgery CNS: Endoscopic Transventricular Lamina Terminalis Fenestration Video 2

Neurosurgery CNS: Endoscopic Transventricular Lamina Terminalis Fenestration Video 1

Neurosurgery CNS: Surgery for Giant PCOM Aneurysms Video 2

Neurosurgery CNS: Surgery for Giant PCOM Aneurysms Video 1

NeurosurgeryCNS: Endovascular-Surgical Approach to Cavernous dAVF

Neurosurgery CNS: Lateral Supraorbital Approach Applied to Anterior Clinoidal Meningiomas Video 4

Neurosurgery CNS: Lateral Supraorbital Approach Applied to Anterior Clinoidal Meningiomas Video 3

Neurosurgery CNS: Lateral Supraorbital Approach Applied to Anterior Clinoidal Meningiomas Video 2

Neurosurgery CNS: Lateral Supraorbital Approach Applied to Anterior Clinoidal Meningiomas Video 1

NeurosurgeryCNS: Surgery of AVMs in Motor Areas

NeurosurgeryCNS: The Fenestrated Yaşargil T-Bar Clip

NeurosurgeryCNS: Cotton-Clipping Technique to Repair Intraoperative Aneurysm Neck Tear Video 3

NeurosurgeryCNS: Cotton-Clipping Technique to Repair Intraoperative Aneurysm Neck Tear Video 2

NeurosurgeryCNS: Cotton-Clipping Technique to Repair Intraoperative Aneurysm Neck Tear Video 1

NeurosurgeryCNS. ‘Double-Stick Tape’ Technique for Offending Vessel Transposition in Microvascular Decompression

NeurosurgeryCNS: Advances in the Treatment and Outcome of Brain Stem Cavernous Malformation Surgery: 300 Patients

3T MRI Integrated Neuro Suite

NeurosurgeryCNS: 3D In Vivo Modeling of Vestibular Schwannomas and Surrounding Cranial Nerves Using DIT

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 7

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 6

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 5

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 4

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 3

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 2

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 1

NeurosurgeryCNS: Corticotomy Closure Avoids Subdural Collections After Hemispherotomy

NeurosurgeryCNS: Operative Nuances of Side-to-Side in Situ PICA-PICA Bypass Procedure

NeurosurgeryCNS. Waterjet Dissection in Neurosurgery: An Update After 208 Procedures: Video 3

NeurosurgeryCNS. Waterjet Dissection in Neurosurgery: An Update After 208 Procedures: Video 2

NeurosurgeryCNS. Waterjet Dissection in Neurosurgery: An Update After 208 Procedures: Video 1

NeurosurgeryCNS: Fusiform Aneurysms of the Anterior Communicating Artery

NeurosurgeryCNS. Initial Clinical Experience with a High Definition Exoscope System for Microneurosurgery

NeurosurgeryCNS: Endoscopic Treatment of Arachnoid Cysts Video 2

NeurosurgeryCNS: Endoscopic Treatment of Arachnoid Cysts Video 1

NeurosurgeryCNS: Typical colloid cyst at the foramen of Monro.

NeurosurgeryCNS: Neuronavigation for Neuroendoscopic Surgery

NeurosurgeryCNS:New Aneurysm Clip System for Particularly Complex Aneurysm Surgery

NeurosurgeryCNS: AICA/PICA Anatomical Variants Penetrating the Subarcuate Fossa Dura

Craniopharyngioma Supra-Orbital Removal

NeurosurgeryCNS: Use of Flexible Hollow-Core CO2 Laser in Microsurgical Resection of CNS Lesions

NeurosurgeryCNS: Ulnar Nerve Decompression

NeurosurgeryCNS: Microvascular decompression for hemifacial spasm

NeurosurgeryCNS: ICG Videoangiography

NeurosurgeryCNS: Inappropiate aneurysm clip applications


32,731
Unique
Visitors
Powered By Google Analytics

Total views

  • 0
%d bloggers like this: