Fronto-Lateral Key Hole Approach versus Unilateral Sub-Frontal Approach for Tuberculum Sellae Meningioma

Background: Tuberculum Sellae meningioma is one of the most challenging surgeriesamong neurosurgeons. Many approaches have been established, attempting to removethe tumor and some of them are supported by an advanced neurosurgical technology.Objective: The aim of present study was to compare the efficacy of the fronto-lateral keyhole approach via an eye brow incision and the unilateral-subfrontal approach inresection of the tuberculum sellae meningiomas. Patients and Methods: This was aretrospective study done on 32 patients with tuberculum sellae meningioma. All patientswere operated upon in Ain shams University Hospitals (Cairo, Egypt) between January2008 and January 2014. There were two different approaches used in this study. Thefronto-lateral key hole approach (16 cases) and the unilateral sub-frontal approach (16cases). Results: Thirty-two patients (eight males and twenty four females) withtuberculum sellae meningioma were included in this study. Age ranged from 31 to 47years (mean: 41 years). The mean age was 42 years in fronto-lateral group and 40 yearsin unilateral sub-frontal group. All patients had visual acuity impairment and visual fielddefects. Duration of presenting symptoms ranged from 3 to 39 months (mean: 18.1months). The mean duration of symptoms was 17.3 months in the fronto-lateral groupand was 18.9 months in the unilateral sub-frontal group. The follow up duration rangedfrom 24 to 36 months (mean: 30 months). Surgical outcome data: as regard theseparameters surgery duration, post-operative cerebral edema and seizures, length ofICU stay and post-operative complications denote that the fronto-lateral group had abetter surgical outcome. Conclusion: According to this study, it seems that, the frontolateralapproach has better surgical outcome than the sub-frontal approach.