Park Chul-Kee, Jung Hee-Won, Yang Seung-Yeob, Seol Ho Jun, Paek Sun Ha, Kim Dong Gyn
Department of Neurosurgery, Seoul National University College of Medicine, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.
Neurosurgery. 2006 Aug;59(2):238-43; discussion 238-43. doi: 10.1227/01.NEU.0000223341.08402.C5.
The visual outcome in patients with tuberculum and diaphragm sellae meningiomas treated with microsurgery was evaluated. Prognostic and diagnostic values of short- and long-term postoperative visual outcome and etiology for postoperative visual deterioration are discussed with special attention.
Clinical data for 30 surgically treated patients with tuberculum and diaphragm sellae meningiomas were reviewed retrospectively. The mean duration of the follow-up period was 75.9 months (range, 12-151 mo). Mean tumor diameter and volume was 25.9 mm (range, 16.3-63.3 mm) and 12.4 cm (range, 2.3-125.6 cm). A visual impairment score was used to assess the short-term (< or =2 wk after surgery) and the long-term (>6 mo after surgery) postoperative visual outcome. Various predictive factors for visual outcome were tested statistically.
Complete resection was achieved in 23 out of 30 (76.7%) patients. Average preoperative, short- and long-term visual impairment scores were 48.2, 43.4, and 40.9, respectively. Favorable visual outcome was achieved in 80% of patients in the short term and 70% in the long term. Short-term postoperative aggravation of visual function was an ominous sign of further aggravation or at least of little hope for recovery, whereas there was a tendency to improve in the long term if short-term postoperative visual function showed favorable outcome. Recurrence or regrowth of tumor fully was responsible for late deterioration of visual function. No significant prognostic factor for visual outcome could be found.
Short-term postoperative visual outcome was a strong indicator of permanent visual outcome after surgery for tuberculum sellae and diaphragm sellae meningiomas.
评估经显微手术治疗的鞍结节及鞍膈脑膜瘤患者的视力预后。特别关注术后短期和长期视力预后的预后及诊断价值，以及术后视力恶化的病因。
回顾性分析30例经手术治疗的鞍结节及鞍膈脑膜瘤患者的临床资料。随访期平均时长为75.9个月（范围12 - 151个月）。肿瘤平均直径和体积分别为25.9毫米（范围16.3 - 63.3毫米）和12.4立方厘米（范围2.3 - 125.6立方厘米）。采用视力损害评分评估术后短期（术后≤2周）和长期（术后>6个月）视力预后。对各种视力预后的预测因素进行统计学检验。
30例患者中有23例（76.7%）实现了完全切除。术前、短期和长期平均视力损害评分分别为48.2、43.4和40.9。80%的患者短期视力预后良好，70%的患者长期视力预后良好。术后短期视力功能恶化是进一步恶化的不祥征兆，或者至少恢复希望渺茫，而如果术后短期视力功能预后良好，则长期有改善的趋势。肿瘤的完全复发或再生长是视力功能晚期恶化的原因。未发现对视力预后有显著影响的预后因素。
术后短期视力预后是鞍结节和鞍膈脑膜瘤手术后永久性视力预后的有力指标。
