Endoscopic endonasal removal of Tuberculum Sellae Meningioma

  • Domenico Solari
  • Ilaria Bove
  • Manuel Colangelo
  • Luigi Maria Cavallo

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Tuberculum sellae meningiomas are a challenging tumor of the suprasellar area, having dural attachments to the tuberculum sellae, chiasmatic sulcus, limbus sphenoidale, and diaphragma sellae. Often, visual impairment is first and the most common symptom of onset. The goals of surgery are vision preservation or improvement with maximal safe resection. A variety of transcranial approaches (TCAs) have been proposed over the time. However, with the advancement of anatomical knowledge and instrumental innovation, extended endoscopic endonasal approaches (EEEAs) have gained wider acceptance. In contrast to the various transcranial approaches, EEA allows the devascularization of the skull base blood supply before tumor resection , avoids brain and optic nerve manipulation, allows the intervening arachnoid plane to protect the vascular supply of the optic apparatus since the tumor is approached from below, allows early bilateral optic nerve decompression at the level of the optic canal. Nasoseptal flap, and recent reconstruction techniques, i.e. “3F technique”, made possible to reduce the rate of postoperative CSF leak, the major disadvantage of this route.

Introduction

This video describes step by step how a case of Tuberculum Sellae meningioma was managed, from diagnosis to postoperative care.

About The Authors

Domenico Solari

Domenico Solari serves as Assistent Professor at the Division of Neurosurgery, Department of Neuroscience and Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II. Dr Solari does research in Neurosurgery, Neuroanatomy, Hypothalamic/pituitary disorders, Endoscopic Endonasal Skull base surgery.

 
Ilaria Bove

Ilaria Bove is a resident at the Division of Neurosurgery, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Naples, Italy. She is currently spendinging one year as Fellow Researcher at the University of Southern California, Los Angeles.

 
Manuel Colangelo

Manuel Colangelo is a resident at the Division of Neurosurgery, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples “Federico II”, Naples, Italy.

 
Luigi Maria Cavallo

Luigi Maria Cavallo serves since 2013 as Associate Professor of Neurosurgery at the Department of Neurosciences Reproductive and Odontostomatological Sciences of the Università degli Studi di Napoli “Federico II”. He completed the residency program in Neurosurgery at the Università degli Studi di Napoli “Federico II”. In 2004 he accomplished PhD in “Surgical Sciences and Advanced Diagnostic and Therapeutic Technologies”. During his career has spent several periods abroad, completing research fellowships at the University of Pittsburgh Medical Center –Pittsburgh (PA), USA, at the University of Virginia, Charlottesville, (VA), USA. Dr Cavallo performed more than 2000 endoscopic endonasal surgeries, targeted to pituitary and different intracranial lesions including craniopharyngiomas, meningiomas, clival chordomas etc. Research activities have been focused, predominantly on: endoscopic endonasal pituitary and skull base surgery; endoscopic skull base anatomy; brain tumors; trigeminal neuralgia, with an overall scientific production of more than 200 peer-reviewed publications of neurosurgical interest, and of 32 book chapters. (h-index: 43; source: Web of Science). So far, he has been invited as a guest and faculty member in more than 80 International courses, meetings and congresses.

 

About this video

Author(s)
Domenico Solari
Ilaria Bove
Manuel Colangelo
Luigi Maria Cavallo
DOI
https://doi.org/10.1007/978-3-031-51235-3
Online ISBN
978-3-031-51235-3
Total duration
19 min
Publisher
Springer, Cham
Copyright information
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2024

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Video Transcript

This video describes the endoscopic endonasal approach for the resection of large tuberculum sellae meningioma in young women. I’m introducing myself. I’m Ilaria Bove, a resident of neurosurgery at the Department of Neurosurgery at Federico II University in Naples.