Transsphenoidal Supradiaphragmatic Intradural Approach - Technical Note -.
- Author:
Woo Tack RHEE
;
Jae Min KIM
;
Il Seung CHOE
;
Koang Hum BAK
;
Choong Hyun KIM
;
Nam Kyu KIM
- Publication Type:Case Report
- Keywords:
Transsphenoidal supradiaphragmatic intradural approach;
Anterior intercavernous sinus;
Diaphragma sella
- MeSH:
Arachnoid;
Cranial Fossa, Anterior;
Craniotomy;
Humans;
Membranes;
Meningioma;
Pituitary Gland
- From:Journal of Korean Neurosurgical Society
1999;28(10):1517-1522
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: Various lesions including tumors occupying in the presellar and suprasellar regions have been traditionally removed by the transcranial approach. The new modified transsphenoidal approaches(TSAs) have been proposed to avoid the craniotomy and to get better surgical view. MATERIALS AND PATIENTS: The sellar floor and presellar anterior cranial fossa were removed through the sublabial transseptal transsphenoidal technique in the "transsphenoidal supradiaphragmatic intradural approach". One tuberculum sella meningioma and a suprasellar Rathke's cleft cyst confined to the pituitary stalk were removed via this approach. RESULTS: The dissection of the anterior intercavernous sinus, diaphragma sella, and arachnoid membrane allowed a wide surgical field of pre- and suprasellar areas and facilitated a safe removal of lesions without significant surgical complications in our cases. CONCLUSION: From the authors' limited experience, the advantages of this technique are as follows: 1) it can be easily applicable through a minor modification of the standard TSA, 2) excellent anatomical exposure of the structures located in the supradiaphragmatic suprasellar cistern, and 3) might be suitable to remove small lesions located in the presellar and adjacent to the pituitary stalk region.
