Around-sellar meningiomas spreading to the optic canal

Abstract

Objective – to optimizate of surgical treatment tactics in patients with around-sellar meningiomas involving optic canal. Materials and methods. The work is based on analysis of surgical treatment results of 93 (31 (33.3 %) men and 62 (66.7 %) women) patients with around-sellar meningiomas involving optic canal. The mean age was 54.6 ± 5.3 years. The tumor involve to the optic canal was recognized preoperatively according to MRI (39 cases, 41.9 %) and as an intraoperative finding (54 cases, 58.1 %). According to this the material was divided into two clinical subgroups: in the first group the early extradural decompression of optic nerve was performed, in the second – during or after tumor removal. Results. The totality of operation: total removal – 34 (36.6 %), subtotal – 19 (20.4 %), partial – 40 (33.0 %). The dynamics of optic nerve function in operated patients was: improvement – in 28 (30.1 %) cases, change for the worse – in 16 (17.2 %) cases, other patients – no changes. Quantity of patients with quality of life according to Karnovsky scale more than 80 points increase from 75 (80.6 %) before operation to 84 (90.3 %) after treatment. Conclusions. Surgical removal of around-sellar meningiomas is often complicated with tumor involving to the optic nerve canal. Bony decompression of optic nerve canal is a necessary and important stage of surgery, that provides optic nerve function preservation and totality of removal.

Keywords

• meningioma, around-sellar localization, optic nerve canal, surgical treatment, optic nerve decompression.