Tuberculum Sellae Meningiomas: Transcranial Approaches Results and Complications

Objective: Tuberculum sellae meningiomas constitute about 5% - 10% of intracranial meningiomas. They are difficult to treat, owing to their close association with the optic nerves, chiasma, and major cerebral arteries. This retrospective study aims to report on the clinical outcome after transcranial approach for treatment of tuberculem sellae meningiomas at our hospital. Patients and Methods: We reviewed patients with tuberculem sellae meningiomas and underwent transcranial surgical approaches for their lesions at Sohag university hospitals over a 4 years period starting from January 2018. The patients’ clinical and radiological data, operative details, degrees of tumor removal, outcomes and complications were reported. Results: There were 17 patients with tuberculem sellae meningiomas with a mean age of 46.3 years. Female patients constituted 70% of cases. Pterional approach was used in 59% of cases and unilateral subfrontal approach was used in 41% of cases. Gross total tumor removal was achieved in 82% of cases. Visual acuity improved in 47%, remained unchanged in 41%, and worsened in 5.9% of patients. Transient post-operative diabetes inspidus and post-operative haematoma in tumor bed each occurred in 5.9% of patients. Conclusion: Transcranial removal of tuberculum sellae meningioma is still considered the standard approach, with high rate of gross total resection and better visual outcome and low mortality and morbidity.

Endoscopic Transsphenoidal Surgery for Pituitary Adenoma. Early Experience in Sohag University Hospitals

Objective: To report the results of our first series of patients undergoing a purely endoscopic endonasal approach for pituitary surgery in Sohag University Hospitals. Patients and Methods: We reviewed 20 consecutive patients during the period from January 2017 to January 2020 with pituitary adenoma who underwent purely endoscopic transsphenoidal resection of their lesions. The patients’ clinical outcomes, degrees of tumor removal, and complications were reported. Results: There were 18 primary and 2 recurrent adenomas (19 nonfunctioning and 1 functioning GH secreting adenoma). The average degree of gross total removal for tumors was 70%, C.S.F leak occurred in 20%, diabetes insipidus in 10% and sellar hemorrhage in 5%. There was no post-operative mortality, vascular injury, sphenoiditis, septal perforation, epistaxis or general complication. Conclusion: A purely endoscopic approach for pituitary adenoma treatment is a safe and effective alternative to the traditional microscopic procedure.