Resection Of Tuberculum Sellae Meningioma By Lateral Supraorbital Approach Craniotomy Without Application Of Clips

Background The pterional approach designed by Professor Yasargil has been proved safe and effective in dealing with lesions at anterior fossa,sellar and suprasellar region,sylvian fissure,which can be successfully used for microsurgical treatment of tumors and vascular lesions.With deeper understanding of neurosurgery,micro-operation and application of modern power system,more and more scholars believe that the effective bone window is the lateral subfrontal part.Hernesniemi designed the lateral supraorbital approach based on pterional approach,and the new approach causes less injury.Treatment of sellar and suprasellar lesions by lateral supraorbital approach has similar effect with pterional approach.Objectives To assess the reliability and safety of the lateral supraorbital approach in the surgical treatment of tuberculum sellae meningiomas.Methods 24 patients operated on by LSO approach were selected during December 2012 to December 2016 at the Department of Neurosurgery at Qilu Hospital Shandong University.By retrospectively analyzing the clinical data,radiological findings,surgical treatment,histology,and outcome of patients,we evaluate the effectiveness of the operative technique in the treatment of TSMs.Statistical methods are chosen by corresponding environment.Results Operations lasted 180 minutes to 400 minutes,with an average of 242.6 minutes.Of the 24 patients,22 patients underwent Simpson ?/? resection,and 2 patients underwent Simpson ? resection.Postoperative pathological grade showed 23 WHOI grade cases,1 WHOII class case.Postoperatively,19 patients improved vision,4 patients had no significant changes,and 1 patient had further deterioration of vision.Postoperative complications included fever in 3 cases and hyponatremia in 3 cases.There were no cases of cerebrospinal fluid leakage,no damage to facial nerve,no death after operation.The postoperative hospital stay ranged from 6 to 14 days,with an average of 8.6 days.Statistically,there was a linear correlation between the time of operation and the maximum diameter of the tumor.From the time of operation and length of postoperative hospital stay,operation by lateral supraorbital approach is superior to the overall standard of surgical treatment for tuberculum sellae meningiomas.Conclusion1.Lateral supraorbital approach can be used for resection of tuberculum sellae meningiomas.2.When using lateral supraorbital approach for resection of meningioma,the time and postoperative hospitalization time and is superior to the same period in Qilu Hospital of Shandong University of surgical resection of tuberculum sellae meningioma in operation.3.Operation time of tuberculum sellae meningiomas by lateral supraorbital approach is associated with the maximum diameter of the tumor.As the maximum diameter of the tumor increases,the time required for the resection of the tumor increases as well.There was no statistical relation among operation time,course of disease,age of diagnosis and length of hospital stay.4.Comparing with pterional approach and the subfrontal approach,lateral supraorbital approach has higher efficiency and brings less trauma.