Endoscopic Endonasal Transpituitary Gland Approach for Resection of Dorsum Sellae Meningioma - Technical Case Report.
Dorsum sellae meningioma
Endoscopic endonasal approach
Pituitary gland
Journal
Operative neurosurgery (Hagerstown, Md.)
ISSN: 2332-4260
Titre abrégé: Oper Neurosurg (Hagerstown)
Pays: United States
ID NLM: 101635417
Informations de publication
Date de publication:
01 12 2019
01 12 2019
Historique:
received:
18
06
2018
accepted:
03
02
2019
pubmed:
20
3
2019
medline:
21
10
2020
entrez:
20
3
2019
Statut:
ppublish
Résumé
Access to a dorsum sellae meningioma is difficult. A transcranial approach, such as a pterional, subtemporal, or transpetrosal method, often requires significant brain retraction and crossing of cranial nerves to access this region. We present here a successful purely endoscopic endonasal transpituitary gland approach for resection of a growing dorsum sellae meningioma. A 74-yr-old woman came to us with dizziness. Magnetic resonance imaging (MRI) demonstrated a mass on the dorsum sellae around the left posterior clinoid. Follow-up MRI examinations over a 3-yr period showed a gradual increase in size of the mass and increasing compression of the left peduncle. To avoid brain retraction, an endoscopic endonasal approach was selected for tumor removal. With this method, we went through the pituitary gland by splitting it, and drilled into the dorsum sellae and clivus to access the front of the tumor. Gross total removal was safely achieved. The patient was asymptomatic and had normal pituitary function after the operation. The present endoscopic endonasal transpituitary gland approach allowed for safe resection of a dorsum sellae meningioma. We consider it to be less invasive for patients because of no need for brain retraction.
Sections du résumé
BACKGROUND AND IMPORTANCE
Access to a dorsum sellae meningioma is difficult. A transcranial approach, such as a pterional, subtemporal, or transpetrosal method, often requires significant brain retraction and crossing of cranial nerves to access this region. We present here a successful purely endoscopic endonasal transpituitary gland approach for resection of a growing dorsum sellae meningioma.
CLINICAL PRESENTATION
A 74-yr-old woman came to us with dizziness. Magnetic resonance imaging (MRI) demonstrated a mass on the dorsum sellae around the left posterior clinoid. Follow-up MRI examinations over a 3-yr period showed a gradual increase in size of the mass and increasing compression of the left peduncle. To avoid brain retraction, an endoscopic endonasal approach was selected for tumor removal. With this method, we went through the pituitary gland by splitting it, and drilled into the dorsum sellae and clivus to access the front of the tumor. Gross total removal was safely achieved. The patient was asymptomatic and had normal pituitary function after the operation.
CONCLUSION
The present endoscopic endonasal transpituitary gland approach allowed for safe resection of a dorsum sellae meningioma. We consider it to be less invasive for patients because of no need for brain retraction.
Identifiants
pubmed: 30888025
pii: 5386567
doi: 10.1093/ons/opz021
doi:
Types de publication
Case Reports
Journal Article
Video-Audio Media
Langues
eng
Sous-ensembles de citation
IM
Pagination
E254-E261Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2019 by the Congress of Neurological Surgeons.