Supraorbital Keyhole Approach Operations were Applied to Resect the Tuberculum Sellea Meningioma

Background: Different modalities of surgical technique were described for resection a tuberculum sellea meningioma. Objective: We conduct this study to review the SOKH approach’s tendency to perform resection of TSM with maximal efficiency, maximal patient’s safety and better patient’s outcome on the long run. Method: Overall 45 cases have been done by senior authors (D. A. Ayyad) between June, 1985 and January, 2011 in Mainz-hospital. We review in our study retrospectively clinical presentation, radiological findings, microneurovascular anatomy, surgical technique, post-OP follow-up, outcome, and the reliability of such technique as practical procedure. Result: Total 16 males and 29 females have undergone the procedure and have been followed up by MRI, mean age 59, mean OP time 124 minutes. Brain MRI request for FU. Grade I meningioma 43 cases, 2 cases of atypical meningioma, the mean follow-up 144 months gross-total resection have been achieved almost in all cases (more than 90%), recidive tumor have been conducted in 3 cases, visual field deterioration 2, no change in visual acuity 7, improve vision acuity and field in 36, pre-OP visual field and telemetry examination were done to all patients, oculomoter nerves roots palsy in 11, no mortality. Discussion: SOKH approach after long-term follow-up could be considered as standard approach for TSM with low morbidity. Decompression of optic canal would reduce the possibility of recidive tumor; anterior clinoidectomy could provide further advantage in the indicated cases. The SOKH approach is proved to be standard option for TSM, with long term improving learning curve.