CRAN-33. ENDOSCOPIC CHALLENGE FOR SELLAR AND PARASELLAR TUMORS: FROM ABOVE OR BELOW

Abstract

INTRODUCTION

Sellar and parasellar tumors are generally remain a neurosurgical challenge due their complexity and the lack of a standardized approach. Several approaches to the sellar and parasellar regions are popular among neurosurgeons; of which supraorbital keyhole and the transsphenoidal approaches. PATIENTS AND

METHODS

We prospectively studied 54 patients with sellar and parasellar tumors who were undergoing 28 from above by endoscope-assisted supraorbital keyhole approach in one hospital and 26 from below by the endoscopic endonasal approach in another hospital by another surgical team. All patients data were collected and analyzed.

RESULTS

The histopathology in this study was limited to meningioma and craniopharyngioma. Although the gross total tumor removal was slightly higher in the supraorbital approach in both groups of meningioma and craniopharyngioma (77.2% Versus 72.7%) and (83.3% Versus 75.0%) respectively, near total was slightly much more in the endonasal group than supraorbital (22.7% Versus 18.1%) and (25.0% Versus 22.7%) for meningioma and craniopharyngioma respectively. Although There was no significant difference regard vision improvement between endonasal and supraorbital in both craniopharyngioma (75.0% Versus 83.3%) and meningioma (27.2% Versus 50.0%). However, percentage of improvement was higher in supraorbital.

CONCLUSION

Although these approaches typically yield an excellent cosmetic result and rapid patient recovery relative to traditional larger craniotomies, they are technically demanding requiring low-profile instrumentation. In conclusion; we believe that after learning and practicing both and other approaches then, Adapt your knowledge to your patient not the patient for your knowledge.