Introduction: Pituitary adenoma, craniopharyngioma and meningioma are common sellar lesions, accounting for more than 90% of sellar tumors. The aim of this study is to assess the reliability and safety of the lateral supraorbital (LSO) approach to remove sellar tumors.
Methods: Between June 2012 and December 2014, 56 patients with neoplastic lesions underwent surgery via the LSO approach. The clinical presentations, neuroradiological findings, microsurgical techniques, and outcome at discharge of these patients were analyzed. In addition, the clinical series in the available literature written in English were also extensively reviewed. 26 (48%) patients were treated for pituitary adenoma; 15 (26%) patients for tuberculum sellae meningioma; and 15 (26%) patients for craniopharyngioma.
Results: Seemingly complete tumor removal was achieved in 51 patients (91%); surgical mortality was 3 patient (5.4%). Postoperatively, no patient had developed cerebrospinal fluid leakage or new visual deficits. One (4%) patient had intracranial infection, and one (1.7%) had a postoperative hematoma. The median Karnofsky score at discharge was 87.4 (range, 0 to 100). The Glasgow outcome scale at discharge was 4.6 (range, 1 to 5). Of all, 51 (91%) patients achieved favorable outcomes.
Conclusions: Sellar tumors can be removed via the LSO approach with relatively low morbidity and mortality. Surgical results with this fast and simple approach are similar to those obtained with more extensive, complex, and time-consuming approaches.
Patient Care: In summary, with the simple and fast LSO approach for
surgery of sellar tumors, our surgical results and tumor recurrence
rates at follow-up are similar to those obtained
using more extensive and time-consuming approaches.
The LSO approach can be used for sellar lesions of all sizes and has a relatively low morbidity and mortality. Based on our experience, we recommend the LSO approach for surgery of sellar tumors.
Learning Objectives: Glasgow outcome scale at discharge and patients achieved favorable outcomes