Surgical treatment for tuberculum sellae meningiomas via extended endoscopic endonasal approach

ZHOU Yuefei; Xue Wen; JIA Pengfei; YUAN Yunchao; YANG Shuangwu; GAO Dakuan

Abstract：Objective To summarize the safety and efficacy of extended endoscopic endonasal approach for tuberculum sellae meningioma resection.Methods The clinical data of 106 patients of tuberculum sellae meningioma who underwent extended endoscopic endonasal approach from January 2018 to June 2023 were retrospectively analyzed,and the efficacy,complications and surgical superiority were also summarized and analyzed retrospectively.The multilayered reconstruction technique was used according to different procedures.Results There were 99 cases(93.4%)of SimpsonⅠresection,5 cases of gradeⅡresection,2 cases of gradeⅢresection,and 1 case(0.9%)of perioperative death.Headache symptoms were relieved in 41 cases(41/47,87.2%),visual acuity was improved in 39 cases(39/53,73.6%).A total of 15 cases(14.0%)had complications after operation,including 3 cases(2.8%)of cerebrospinal fluid rhinorrhea,re-operation repair administered;5 cases(4.7%)of simple intracranial infection,4 cases(3.8%)of visual impairment,1 case(0.9%)of bleeding in surgical area,1 case(0.9%)of transient diabetes insipidus,and 1 new case(0.9%)of hypopituitarism.All patients had no recurrence within the 6-72 months of following-up after surgery.Conclusions Extended endoscopic endonasal approach is an option for the surgical treatment of tuberculum sellae meningioma because of its minimal invasion,shorter surgical time and achievement of Simpson grade I resections in selected patients,but is not suitable for all tuberculum sellae meningiomas,and should be applied under strict surgical indication.