Role of Transcranial Endoscopy in Management of Sellar and Suprasellar Lesions Projecting in to Ventricular System

Management of Sellar and Suprasellar Lesions

Abstract

Introduction: This article is aimed to evaluate the role of Transcranial Endoscopy in management of sellar and suprasellar lesions projecting in to ventricular system with the particular focus on pros and cons of all the approaches surgeon take in the removal of the lesion. Subjects and Methods : 46 patients who had undergone tumor resection employing transcranial endoscopic surgical approach. They were included in the study. After the approval from the Institutional Ethical Committee, informed consent form was provided to all 46 patients and along with the brief presentation about study. After getting the consent, retrospective review of the case files of the patients was carried out. We went through symptoms presented by patients, location of tumor and its relation with adjacent structures, their preoperative and post-operative radiological images and results of Opthalmological examinations, hispathological examinations, endocrinological tests and neuropsychological tests. In addition to this, all the complications occurred during surgery were noted. Results: Three patients developed symptoms of cerebrospinal fluid leak (CSF). two of patients recovered on their own within 3 days after the occurrence of CSF. Common neurological manifestations were sown in figure 1 in which headache was present in 45 patients, vomiting were noted in 39 patients, impaired vision were found in 35 patients, Diplopia and Ptosis were noted in 5 and 4 patients respectively. Conclusion: The Transcranial Endoscopy is still an effective approach. High-resolution 3D MPR MRI can be helpful to not only identify the shape of the tumor and involvement of optical canal but also to decide the best suited approach for a particular case.