Abstract
Aims: To evaluate the surgical treatment of parasellar meningiomas.
Material and methods: A retrospective study of the clinical histories and imaging studies of 33 patients diagnosed of meningiomas located in the parasellar region who were admitted to our Unit over the last 12 years has been performed. Under this name, we considered an area surrounding the sella turca including deeply located structures. These lesions are difficult to approach and carry a high degree of morbidity and mortality.
Resuts: Complete macroscopic tumour removal was achieved in 84.4% of the cases, three tumors relapsing (9.1%) over a mean follow-up period of 39.7 months. The preoperative percentage of affectation of cranial nerves was reduced by 15.6%. Post-surgery mortality was 9.1% with an overall mortality along the follow-up period of 21.21%. The most important cause of morbidity-mortality was pulmonary thromboembolism. Neurological complications during the postoperative period included three cases with hemiparesis and 15 adquired cranial nerve deficits in nine patients, most of which were transient. A 60% of the cases (20 patients) did not have complications, either neurological or general. At the end of the follow-up, 75% of the patients had a Karnofski index between 90 and 100.
Conclusions: Despite their volume, which is usually important, and the involvement of structures such as the cranial nerves and vessels of the circle of Willis, surgical treatment of this type of tumor offers acceptable results in terms of morbidity and mortality. If complete macroscopic removal of the tumor can be achived, the possibilities of relapse are low, although the prognosis is considerably worsened if the removal is not complete or if the tumor relapses, Finally, the roles of radiosurgery and conventional radiation therapy as complementary treatment for this type of tumor are discussed.