Turkish Neurosurgery 2023 , Vol 33 , Num 2
Endoscopic Endonasal Approach Limitations and Evolutions for Tuberculum Sellae Meningiomas: Data from Single-Center Experience of Sixty Patients
1Taksim Education and Research Hospital, Department of Neurosurgery, Istanbul, Turkey
2Kocaeli State Hospital, Department of Neurosurgery, Kocaeli, Turkey
3Kocaeli University, Faculty of Medicine, Department of Neurosurgery, Kocaeli, Turkey
DOI : 10.5137/1019-5149.JTN.38489-22.2 AIM: To determine the limits, to show the effect of tumor consistency on resection rates and to present the sinonasal morbidity rate in patients with tuberculum sellae meningiomas who underwent endoscopic endonasal approach.

MATERIAL and METHODS: We reviewed the medical data, radiological images, and surgical videos of the patients with pathologically confirmed meningiomas originating from the tuberculum sellae and they were operated via endoscopic endonasal approach between August 1997 and December 2020. We used our endoscopic classification based on infrachiasmatic corridor. In this classification, tumors were divided into those within the infrachiasmatic corridor and proximity of the optic nerve, internal carotid artery, and anterior artery complex and those outside the infrachiasmatic corridor.

RESULTS: Gross total resection was achieved in 45/60 (75%) patients. We found that tumor consistency was statistically significant on resection rates. Simultaneously, tumor median diameters on the anteroposterior (?21.15 mm), transverse (?19.75 mm), and superoinferior (?15 mm) axes were statistically significant on resection rates.

CONCLUSION: In summary, the most important factor in selecting the surgical technique is the tumor size. Infrachiasmatic corridor boundaries are the limitations of endoscopic approach. These limitations can change based on surgeon?s experience. Also, tumor consistency is a factor that affecting degree of tumor resection rates. Keywords : Endoscopic, Tuberculum sellae, Meningioma, Infrachiasmatic, Classification

Corresponding author : Savas CEYLAN, ssceylan@yahoo.com