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03-FEBRUARY-2003 SAMAR MAHMOUD
FUDEH 40 YEARS TUBERCULUM SELLA MENINGIOMA WITH INTRACANALICULAR
EXTENSION TO THE RIGHT OPTIC NERVE.
Anamnesis
The patient came to the clinic 18-January-2003
complaining of decreased vision right eye 12 months
ago during the third month of pregnancy.
On examination: the patient had temporal scatoma
of the right eye field with decreased acuity.
MRI done recently showing huge tuberculum sella
meningioma with massive suprasellar extension
and intracanalicular extension to the right
optic nerve.
Bifrontal osteoplastic craniotomy with
reflection of the bone flap to the left ear.
Approach to the chiasmal region with dissection
and anatomical preservation of the olfactory
tracts. The meningioma was attacked in the
middle line and piece-meal resection was
performed. The pituitary stalk and all the
neural structures were respected and preserved.
Total resection of the tumor was achieved and
the matrix was coagulate and resected.
Routine closure of the wound.
Smooth postoperative recovery. The patient was
kept for one day in the ICU.
Follow Up
The patient was followed for 4 years after
surgery. The visual functioned normalized and
olfaction preserved. MRI of the brain was done
several times after surgery, the last one done
19-February-2007 which confirmed no recurrence
of the tumor. The patient was treated for
temporal lobe epilepsy which took place 13
months after surgery. The last time was seen
19-February-2007.
Comments
The olfactory tracts were preserved during
surgery and functional recovery after surgery
was achieved.
For more details about tuberculum sella
meningiomas
click here!
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