AI Article Synopsis
- A study evaluated the trans-eyebrow supraorbital keyhole approach (TSKA) in treating tuberculum sellae meningiomas (TSMs) in 30 patients, finding it effective and minimally invasive.
- Results showed high rates of gross total resection (90%) and improvement in visual impairment in over half of the patients, with only one recurrence noted after nine years.
- The TSKA approach not only maintained good cosmetic outcomes but also had no severe complications, supporting its use as a viable surgical alternative for TSMs.
Article Abstract
Background: Approach selection paradigm for tuberculum sellae meningiomas (TSMs) is still a point of discussion. The trans-eyebrow supraorbital keyhole approach (TSKA) is a minimally invasive transcranial approach and has been used for the treatment of TSMs during recent years. In this study, we presented a series of 30 cases of TSMs treated via TSKA with a long-term follow-up.
Method: Thirty patients with TSMs underwent surgery via TSKA between December 2006 and August 2018. The medical data and follow-up results were retrospectively analyzed.
Results: A total of 5 males and 25 females were included in this study. Three patients presented with recurrent TSMs. The mean tumor size was 25.3 ± 7.3 mm (range, 10-48 mm). The mean follow-up period was 58.0 months (interquartile range, 33.5-86.3 months). Gross total resection (GTR) was achieved in 27 patients (90.0%). One recurrence (3.3%) occurred 9 years after surgery. Out of 29 patients with preoperative visual impairment, 17 (58.6%) improved, eight (27.6%) remained stable, and four (13.8%) deteriorated. No peri-operative death, CSF rhinorrhea, or permanent endocrine dysfunction occurred. All patients exhibited satisfactory cosmetic results. At the last follow-up, the glasgow outcome scale score was five in 27 patients (90.0%).
Conclusion: The TSKA is characterized by minimal invasion with a satisfactory cosmetic outcome. Based on the tumor characteristics and surgeon's experience, this approach can be employed as an alternative minimally invasive approach for the treatment of TSMs.
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| http://dx.doi.org/10.1007/s11060-019-03128-9 | DOI Listing |
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