Endoscopic Endonasal Transplanum-Transtuberculum Sellae Approach for the Resection of a Diaphragma Sellae Meningioma.

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Endoscopic Endonasal Transplanum-Transtuberculum Sellae Approach for the Resection of a Diaphragma Sellae Meningioma.

J Neurol Surg B Skull Base. 2018 Apr;79(Suppl 3):S271-S272

Authors: Barbero JMR, Montaser AS, Todeschini AB, Shahein M, Otto BA, Carrau RL, Prevedello DM

Abstract
The endoscopic endonasal approach (EEA) provides a direct access to diaphragma sellae meningiomas. We present a case of a 56-year-old-female with an incidentally diagnosed sellar/suprasellar lesion with no hormonal deficit; thus, she opted for conservative management initially. During her annual follow-up appointment with her ophthalmologist, it was noticed that the patient had right eye peripheral deficit on formal visual field testing. Magnetic resonance imaging (MRI) revealed an enlargement of the sellar/suprasellar mass, causing displacement of the optic chiasm. A transplanum-transtuberculum EEA was performed. Gross-total removal was achieved and closure was done in a multilayer fashion using a collagen matrix, nasoseptal flap. Histopathological examination confirmed a meningioma WHO grade I. There were no intra- or postoperative complications. At 4-year-follow-up, the patient has stable vision and MRI brain showed no recurrence. The link to the video can be found at: https://youtu.be/xY8T9hotlDs .

PMID: 29588897 [PubMed]

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