Keywords
tuberculum sellae - meningioma - skull base - optic nerve decompression
Fig. 1 (A) Archiform incision starting at the tragus and extending to the contralateral midpupillary line behind hairline. Pericranial flap harvested. (B) “V” shape zygomatic arch incision on both anterior and posterior zygoma roots. (C) Masseter muscle preserved attached to the zygoma. (D) MacCarty keyhole behind the frontozygomatic suture and bone cuts performed for the modified one piece cranio-orbital-zygomatic craniotomy.
Fig. 2 (A) Optic nerve encased 360 degrees by tumor and pushed upward against the falciform ligament. (B) After dissections of both the neural structures and internal carotid artery (ICA) and the tumor devascularized, it is debulked and splitted in small pieces for secure removal. (C) Final piece still attached to the tuberculum sellae under the right optic nerve. (D) Arrows demonstrating the nerve contusion at the falciform ligament caused by tumor growth. The optic canal is all opened and the anterior clinoid removed.
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