Endoscopic Endonasal Transplanum–Transtuberculum Sellae Approach for the Resection of a Diaphragma Sellae Meningioma

Juan M. Revuelta Barbero; Alaa S. Montaser; Alexandre B. Todeschini; Mostafa Shahein; Bradley A. Otto; Ricardo L. Carrau; Daniel M. Prevedello

doi:10.1055/s-0038-1624587

Journal of Neurological Surgery Part B: Skull Base, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2018; 79(S 03): S271-S272
DOI: 10.1055/s-0038-1624587

Skull Base: Operative Videos

Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Endonasal Transplanum–Transtuberculum Sellae Approach for the Resection of a Diaphragma Sellae Meningioma

Juan M. Revuelta Barbero

¹Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, United States

,

Alaa S. Montaser

¹Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, United States

²Department of Neurosurgery, Ain Shams University Faculty of Medicine, Cairo, Egypt

,

Alexandre B. Todeschini

¹Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, United States

,

Mostafa Shahein

¹Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, United States

,

Bradley A. Otto

¹Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, United States

³Department of Otolaryngology–Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, United States

,

Ricardo L. Carrau

¹Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, United States

³Department of Otolaryngology–Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, United States

,

Daniel M. Prevedello

¹Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, United States

³Department of Otolaryngology–Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio, United States

› Institutsangaben

Abstract

The endoscopic endonasal approach (EEA) provides a direct access to diaphragma sellae meningiomas. We present a case of a 56-year-old-female with an incidentally diagnosed sellar/suprasellar lesion with no hormonal deficit; thus, she opted for conservative management initially. During her annual follow-up appointment with her ophthalmologist, it was noticed that the patient had right eye peripheral deficit on formal visual field testing. Magnetic resonance imaging (MRI) revealed an enlargement of the sellar/suprasellar mass, causing displacement of the optic chiasm. A transplanum–transtuberculum EEA was performed. Gross-total removal was achieved and closure was done in a multilayer fashion using a collagen matrix, nasoseptal flap. Histopathological examination confirmed a meningioma WHO grade I. There were no intra- or postoperative complications. At 4-year-follow-up, the patient has stable vision and MRI brain showed no recurrence.

The link to the video can be found at: https://youtu.be/xY8T9hotlDs.

Keywords

diaphragma sellae meningioma - endoscopic endonasal approach - expanded approaches - transplanum - transtuberculum

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