Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Acta Neurochir (Wien). 2023 Oct;165(10):2925-2929. doi: 10.1007/s00701-023-05714-3. Epub 2023 Jul 15.
The main challenge in tuberculum sellae meningioma (TSM) resection is the safe dissection of the optic nerves, which many a times are compressed and distorted by the tumor. While intuitive, an approach from the side of predominant tumor extension makes tumor dissection from the medial surface of the ipsilateral optic nerve rather blind. We describe here a contralateral supraorbital eyebrow approach (c-SEA) to address this "blind spot."
c-SEA was performed using a 2 × 2 cm craniotomy. The patient improved after surgery and postoperative imaging confirmed the totality of the tumor resection.
c-SEA can be an excellent minimally invasive option for asymmetric TSM.
鞍结节脑膜瘤(TSM)切除的主要挑战在于安全地分离视神经,视神经常常受到肿瘤的压迫和扭曲。虽然直观,但从肿瘤主要延伸的一侧入路进行手术,使得从同侧视神经的内侧表面进行肿瘤分离变得盲目。我们在这里描述一种对侧眉弓上入路(c-SEA)来解决这个“盲点”。
采用 2×2cm 的颅切开术进行 c-SEA。患者术后改善,术后影像学检查证实肿瘤完全切除。
c-SEA 对于不对称性 TSM 是一种极好的微创选择。