Outcome Assessment After Surgical Treatment of Tuberculum Sellae Meningiomas- A Preliminary Report.

AIM To evaluate the endocrinological and ophthalmological results of the tuberculum sellae meningioma surgery. MATRRIAL and METHODS: A total of 18 patients diagnosed with tuberculum sellae meningioma received surgical treatment at Neurosurgery Clinic at Military Medical Institute in Warsaw from January 2010 to July 2012. This analyzed group of patients included 15 females and 3 males at a mean age of 50.5 years (ranging from 30 to 73; SD ± 13.4). In the pre-operative and post-operative periods, all patients underwent magnetic resonance imaging of the head according to a uniform protocol, eye examinations with assessment of visual acuity and field of vision, as well as endocrine tests to evaluate the hypothalamic-pituitary axis (including urine specific gravity and osmolality as well as blood cortisol, TSH, fT3, and fT4 levels). All patients underwent surgical treatment of the tumor via unilateral subfrontal craniotomy, achieving macroscopically complete tumor removal (Simpson grade II resection). RESULTS The use of the unilateral subfrontal approach helped improve vision in 88% of the treated patients. Endocrine tests revealed no hypothalamic-pituitary axis dysfunction. The most commonly diagnosed meningiomas of the area were meningothelial (77%) and transitional (12%) meningiomas. CONCLUSION Surgical treatment of tuberculum sellae meningiomas via the unilateral subfrontal approach is a safe technique with no significant complications. Visual improvement was observed in 88% of the patients who had received this treatment. There were no hormonal disturbances in patients operated via the subfrontal approach either prior to or after the procedure, which suggests that surgical treatment of tuberculum sellae meningiomas has no effect on pituitary endocrine function.