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JOURNAL OF NEUROSURGICAL SCIENCES

A Journal on Neurosurgery


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Journal of Neurosurgical Sciences 2018 Jan 04

DOI: 10.23736/S0390-5616.18.04167-X

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Surgical outcome of tuberculum sellae and planum sphenoidale meningiomas based on Sekhar-Mortazavi tumor classification

Lorenzo GIAMMATTEI , Mahmoud MESSERER, Amani BELOUAER, Roy T. DANIEL

Department of Neurosurgery, University Hospital of Lausanne, Lausanne, Switzerland


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BACKGROUND: Results from surgical series of tuberculum and planum sphenoidale meningiomas tends to be heterogeneous. Sekhar-Mortazavi tumor classification system has been recently proposed in order to predict the surgical risk and outcome.
METHOD: We retrospectively reviewed a consecutive series of tuberculum and planum sphenoidale meningioma operated at our institution between 2009 and 2016. Sekhar-Mortazavi tumor classification was applied to classify these tumors and evaluate the outcome.
RESULTS: Twenty seven patients were included in the study. There were 22 females (81%) and 5 males
(19%). The mean age was 54 years (range 33-78). According to Sekhar-Mortazavi tumor classification: 14 patients (51.85 %) were class I, 11 (40.74%) patients were in class II and 2 patients (7.41%) were in class III. Twenty one patients (77.7%) presented with visual symptoms and deficits at preoperative neuro- ophtalmological examination. Sekhar-Mortazavi class I tumors had a post-operative visual improvement in 77.7% of cases while patients in Sekhar-Mortazavi class II-III had a post-operative visual improvement in 66.6% of cases (p=0.5). No patient had deterioration of optic nerve/chiasmal function following surgery. Gross total resection was obtained in 25 patients (92.5 %) without any significative difference between class I and Class II-III tumors. Permanent endocrine dysfunction was observed only in one patient in SM Class II tumor. 3 patients (11%) showed a post-operative persistant cranial nerve deficit (2 patients were anosmic and one patient had a trochlear nerve deficit). None of the patients showed post- operative CSF leak. No onset of new seizures was observed post-operatively. There was no mortality or major morbidity in this series.
CONCLUSIONS: Transcranial surgery provided very satisfying results with respect to visual and endocrine outcomes with very low surgical morbidity. The Sekhar-Mortazavi classification showed a trend towards better visual outcomes in Class I tumors. The classification system is easy to apply and could therefore prove useful to compare results between studies reported in literature, especially when comparisons are made between transcranial and endonasal surgery.


KEY WORDS: Planum sphenoidale meningioma - Tuberculum sellae meningioma - Skull-base - Microsurgical removal - Visual outcome

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Publication History

Article first published online: January 4, 2018
Manuscript accepted: January 2, 2018
Manuscript revised: December 5, 2017
Manuscript received: July 28, 2017

Cite this article as

Giammattei L, Messerer M, Belouaer A, Daniel RT. Surgical outcome of tuberculum sellae and planum sphenoidale meningiomas based on Sekhar-Mortazavi tumor classification. J Neurosurg Sci 2018 Jan 04. DOI: 10.23736/S0390-5616.18.04167-X

Corresponding author e-mail

Lorenzo.giammattei@chuv.ch