Evaluation of Transcranial Approach for Management of Suprasellar Meningiomas

Abstract

Objective: to evaluate the surgical outcome, the perioeperative complications and technical challenges of various transcranial approaches for excision of the suprasellar meningiomas.

Methods: A prospective randomized clinical study which is conducted on 20 patients with suprasellar meningiomas starting from June 2021till october 2023. All patients are evaluated clinically and radiographically preoperatively. Intraoperaive technical challenges are documented. Postoperaive evaluation included radiological assessment to evaluate the extend of resection, postoperative hospitalization, operation time, blood loss, and intraoperative complications.

Results: This study included 8 males and 12 females. The mean ago was 49.2 years old. Visual affection was the most common preoperative manifestation (100%% of patients for visual acuity and 80% for visual field). Maximal tumor diameter for was 5.2 cm. Gross total resection was achievable in 90% of cases.  Post-operative assessment of the visual field and acuity revealed 70% with pre-operative visual affection showed post-operative improvement. Complications included, seizures, disturbed conscious level, hematoma, weakness, frontalis nerve palsy, subgaleal collection.

Conclusion: The transcranial route still reliable for management of suprasellar meningiomas providing a safe and efficient route to achieve gross total resection with minimal complications. Vascular encasement and large sized tumors always favor a transcranial route to seek a desirable outcome.