Tuberculum Sella Meningioma: Surgical Management and Results with Emphasis on Visual Outcome

Abstract

Background Tuberculum sella meningioma form a distinct surgical entity with significant morbidity for the patient due to early and profound visual involvement. Surgical treatment of tuberculum sella meningioma is challenging in view of the proximity of vital neuro-vasculature. These lesions may be approached via a high-route (trans-cranial) or a low-route (trans-sphenoidal). Materials and Methods The authors present a consecutive series of 36 patients, operated by the first author from 1996 onward, with an analysis of clinical presentation (emphasizing visual deterioration), imaging features, operative approaches, and outcome with postoperative visual status. Results There were 36 patients (72 eyes) in the series, 75% females and 25% males. The mean age of patients was 48.05 ± 10.02 years. In all, 88.89% had visual diminution, 50% had headache, 5.56% had behavioral changes, and 2.78% had seizures. The mean tumor size was 4.01 ± 1.01 cm. The frontotemporal approach was employed in 66.67% of patients, and all patients underwent a right-sided approach. There was no significant difference between improvement in the vision between the right eye and left eye, despite the fact that right-sided approach was employed in nearly cases. Conclusion While tuberculum sella meningioma have profound morbidity in terms of visual deterioration, timely surgical intervention may help patients gain serviceable vision postoperatively. We advocate the trans-cranial approach and find no difference in visual outcomes on employing right-sided approach, regardless of the side with worse vision.

Outcome of Visual Function after Removal of Tuberculum Sellae Meningioma Presenting with Scotoma at the Lower Visual Field Center

“…The mean size for the removal of the tuberculum sellae meningiomas has been reported to be 20-40 mm. 1 , 13 , 14 ) Tumor size in our patients was 10 and 25 mm, respectively. The size in the first patient was relatively small, and visual field deficits were relatively limited.…”

Visual Outcomes after Suprasellar Meningioma Resection: A Retrospective Cohort Study and a Machine Learning-Based Predictive Model

“…The main clinical manifestation of suprasellar meningiomas is visual impairment, 5,12 more prevalent in tumors originat-ing from TS, which makes the surgical resection of these lesions more beneficial. 2,13 According to our research, patients with TS-originating meningiomas exhibited a higher incidence of preoperative visual disturbances. Our analysis also revealed greater VA/VF deficits in OLF meningiomas, which may be attributable to the enormous tumor size of the included patients.…”

Clinical Profile of Tuberculum Sellae Meningiomas Based on Scoring System: An Institutional Experience in Indonesia

“…In this study, we found no significant relationship between higher scores for optic canal invasion and decreased visual acuity or vascular invasion (Table 3). Several studies have described various factors affecting visual outcomes, such as young age and short symptom duration, which are good prognostic factors for visual outcomes [2,[16][17][18]. In addition, preoperative visual function, anterior cerebral artery encasement, and tumor size must be considered as influencing factors.…”