Tuberculum Sellae Meningioma Resection: Technical Nuances on the Frontopterional Approach

Oriela Rustemi; Renato Scienza; Alessandro Della Puppa

doi:10.1055/s-0037-1620245

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2018; 79(S 02): S225-S226
DOI: 10.1055/s-0037-1620245

Skull Base: Operative Videos

Georg Thieme Verlag KG Stuttgart · New York

Tuberculum Sellae Meningioma Resection: Technical Nuances on the Frontopterional Approach

Oriela Rustemi

¹Department of Neurosurgery, Padua University Hospital, Padua, Italy

,

Renato Scienza

¹Department of Neurosurgery, Padua University Hospital, Padua, Italy

,

Alessandro Della Puppa

¹Department of Neurosurgery, Padua University Hospital, Padua, Italy

› Author Affiliations

Abstract

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Keywords

tuberculum sellae meningioma - pterional approach - cisternal anatomy - optic canal

Fig. 1 (A) Preoperative MRI shows a contrast-enhanced tuberculum sellae lesion, suspicious of meningioma. (B) The left optic nerve (II c.n.) is evidenced through a left pterional approach. The II c.n. is compressed by the meningioma. (C) The left optic canal is unroofed and the sign of optic nerve compression is indicated by blue asterisks (*). (D) Intraoperative image after removing the left part of the meningioma showing the left optic nerve, internal carotid artery (ICA) and posterior communicating artery (PCom). (E) Intraoperative image after the removal of the meningioma showing bilateral optic nerves and ICAs, and the tuberculum meningioma's base. (F) Final intraoperative view showing bilateral oculomotor nerve (III c.n.), left II c.n., left ICA, and the conserved pituitary stalk. (G) Postoperative CT shows the complete removal of the meningioma. CT, computed tomography; MRI, magnetic resonance imaging.

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Fig. 1 (A) Preoperative MRI shows a contrast-enhanced tuberculum sellae lesion, suspicious of meningioma. (B) The left optic nerve (II c.n.) is evidenced through a left pterional approach. The II c.n. is compressed by the meningioma. (C) The left optic canal is unroofed and the sign of optic nerve compression is indicated by blue asterisks (*). (D) Intraoperative image after removing the left part of the meningioma showing the left optic nerve, internal carotid artery (ICA) and posterior communicating artery (PCom). (E) Intraoperative image after the removal of the meningioma showing bilateral optic nerves and ICAs, and the tuberculum meningioma's base. (F) Final intraoperative view showing bilateral oculomotor nerve (III c.n.), left II c.n., left ICA, and the conserved pituitary stalk. (G) Postoperative CT shows the complete removal of the meningioma. CT, computed tomography; MRI, magnetic resonance imaging.