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Endonasal Endoscopic Transsphenoidal Resection of Tuberculum Sella Meningioma with Anterior Cerebral Artery Encasement.

Dhandapani S, Negm HM, Cohen S, Anand VK, Schwartz TH - Cureus (2015)

Bottom Line: Moreover, the medial optic canals were opened and the optic nerves decompressed.A gasket seal closure with a nasoseptal flap was performed, and the patient was discharged on postoperative day four with improved vision.The absence of luminal narrowing can be used to assure the likelihood of a safe arachnoid plane.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh.

ABSTRACT
Anterior cerebral artery (ACA) encasement is often considered a contraindication for an endonasal endoscopic transsphenoidal approach. We report a patient with a tuberculum sella meningioma with ACA encasement, in whom a gross total excision was achieved through an endonasal endoscopic transsphenoidal transtuberculum, transplanum approach. The tumor was sharply dissected along the left ACA using meticulous bimanual sharp dissection after internal decompression. Moreover, the medial optic canals were opened and the optic nerves decompressed. A gasket seal closure with a nasoseptal flap was performed, and the patient was discharged on postoperative day four with improved vision. This case highlights the ability to remove planum and tuberculum meningiomas with vascular encasement through an endonasal endoscopic approach with the potential for safe vascular dissection. The absence of luminal narrowing can be used to assure the likelihood of a safe arachnoid plane.

No MeSH data available.


Related in: MedlinePlus

Postop Radiology
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FIG4: Postop Radiology

Mentions: Postoperatively, the patient had improved vision. MRI (Figure 4) showed a gross total excision of the tumor with bilateral ACAs floating in subarachnoid space, complete decompression of both optic canals, and the vascularized nasoseptal flap in-situ.


Endonasal Endoscopic Transsphenoidal Resection of Tuberculum Sella Meningioma with Anterior Cerebral Artery Encasement.

Dhandapani S, Negm HM, Cohen S, Anand VK, Schwartz TH - Cureus (2015)

Postop Radiology
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4587944&req=5

FIG4: Postop Radiology
Mentions: Postoperatively, the patient had improved vision. MRI (Figure 4) showed a gross total excision of the tumor with bilateral ACAs floating in subarachnoid space, complete decompression of both optic canals, and the vascularized nasoseptal flap in-situ.

Bottom Line: Moreover, the medial optic canals were opened and the optic nerves decompressed.A gasket seal closure with a nasoseptal flap was performed, and the patient was discharged on postoperative day four with improved vision.The absence of luminal narrowing can be used to assure the likelihood of a safe arachnoid plane.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh.

ABSTRACT
Anterior cerebral artery (ACA) encasement is often considered a contraindication for an endonasal endoscopic transsphenoidal approach. We report a patient with a tuberculum sella meningioma with ACA encasement, in whom a gross total excision was achieved through an endonasal endoscopic transsphenoidal transtuberculum, transplanum approach. The tumor was sharply dissected along the left ACA using meticulous bimanual sharp dissection after internal decompression. Moreover, the medial optic canals were opened and the optic nerves decompressed. A gasket seal closure with a nasoseptal flap was performed, and the patient was discharged on postoperative day four with improved vision. This case highlights the ability to remove planum and tuberculum meningiomas with vascular encasement through an endonasal endoscopic approach with the potential for safe vascular dissection. The absence of luminal narrowing can be used to assure the likelihood of a safe arachnoid plane.

No MeSH data available.


Related in: MedlinePlus