Microsurgical removal of sellar region tumors via pterional approach: a report of 46 cases

Objective To summarize the clinical experience of the microsurgical operation in sellar region tumors via the pterional approach. Methods The clinical data were reviewed in forty-six patients hospitalized in First Clinical Medical College of Shanxi Medical University from December 2002 to September 2005 . Clinical features, CT or MRI characteristics of the patients were studied. The operative results and complications were discussed also in microsurgical techniques, and the factors affecting the choice of the pterional approach were analyzed. Results Of 46 cases, 37 obtained good results, and the total resection rate of sellar region tumors was 80.4%.One patient died after the surgery. Two patients were facial paralysis. Five patients had diabetes insipidus and electrolyte disorder. There was no recurrence after follow up for 10 months. Conclusion The pterional approach for removing sellar region tumors has the advantages of short working distance, minimal injury to the neural structures and sufficient exposure of the tumor. It is a better opration for successful total removal of the giant or large pituitary adenoma which growing toward the suprasellar and parasellar extension, the craniopharyngioma, crista sphenoidalis meningioma and the tuberculum sellae meningioma, and could improve the patients’ life quality and decrease the recurrence of the tumor.