Tuberculum Sellae Meningioma Microsurgery Surgical Approach Choice And Clinical Analysis

Objective Analysis of all kinds of tuberculum sellae meningioma microsurgery into the road choice and surgical results, thus for clinical surgery of tuberculum sellae meningioma choose into the road and prognosis assessment to provide the reference.Methods A retrospective analysis was made on49cases of tuberculum sellae meningioma operated from Jan,2002to July,2011in department of neurosurgery of Anhui provincial hospital which all removed by using microsurgical technique with five different surgical approach. The removal rate, surgery effect and complications were analysed.Results Microsurgery resection in49cases:the amount of unilateral down into the road18cases, the frontal craniotomy coronary down into the road in15cases, coronary craniotomy longitudinal split into the road before7cases, locked into the way the orbit hole in5cases, wing point or improved wing point into the road4cases. According to the Simpson grade, grade II was achieved in40cases, grade III was9cases. The resection rate (Simpson level II) was81.6%. During all the cases,1death was occurred which may result from tumor apoplexy before the surgery and postoperative multiple organ failure(MOF).38patients were with merger ision loss and visual field defects preoperate, and20cases were improved obiviously after surgery,17case with no manifest change, and1case aggravated.Conclusion Microscopic surgery is the main way of remove tuberculum sellae meningioma and the surgical approach should be chosed according to the following4points:(1) the growth pattern of tumor and the size;(2)degree of eye vision (3) the habit of surgeon;(4) surgery time and brain damage. The efficacy of surgery mainly based on the degree of eye vision, length of disease course, protection of nerve, vessels and tissue during the operation, and finally, the removl rate, etc. Through the analysis of the49cases microsurgery early diagnosis and delicate surgery, makes the tuberculum sellae meningioma can win complete resection, in decrease the mortality rate at the same time, the postoperative complications include the improvement of the vision can get a degree of improvement. Surgical outcomes, through the49patients microsurgery analysis tuberculum sellae meningioma blood supply to the most rich, perioperative, improve the exquisite sex, perfect the microsurgery techniques, save the timing of the operation, to reduce the total intraoperatie bleeding and postoperative complications of all possible is especially important; The operation of the fine microscopic operation, the key is to protect the visual function, can reduce the optic nerve damage and pull, in separation and optic nerve adhesion to tumor patient, careful, be careful to avoid damage the blood supply is on, and the surgical damage factor sometimes even influence visual acuity improved the key factors.