Effect of early optic canal unroofing on the outcome of visual functions in surgery for meningiomas of the tuberculum sellae and planum sphenoidale
Meningiomas affecting the visual pathway originate from the basal meninges of tuberculum sellae, planum sphenoidale, chiasmatic sulcus and from diaphragma sellae.
Planum sphenoidale and processus clinoideus were the origin of tumor in 18.
Meningiomas of the sellar/ parasellar region can arise from cavernous sinus, planum sphenoidale
, diaphragma sellae, anterior clinoid processes, tuberculum sellae, medial lesser wing of sphenoid and optic nerve sheath.
3,4) These tumors most often arise from the sphenoid wing, but additional sites include clinoid, planum sphenoidale
, frontoparietal area, and olfactory groove.
Meningiomas in this region originate from the tuberculum sella, anterior clinoid processes, diaphragma sellae, planum sphenoidale
and upper clivus (Figure 9).
Endoscopic surgical procedure of cases Transsphenoidal pituitary surgery 60 Clivus biopsy 1 Anterior skull base CSF leaks 8 Endoscopic medial maxillectomy 9 for inverting papilloma Malignant melanoma 3 Angiofibroma 1 Ossifying fibroma 3 Sphenoid sinus angioma 1 Meningocele 1 Intranasal dermoid cyst 1 Orbital apex cyst 1 Optico-carotid recess fungal mass 4 Removal foreign body (bullet) 1 from planum sphenoidale
The fatty mass seen on fat-saturated MRI actually represented yellow marrow in the corpus sphenoidale instead of air.
It was not until CT was performed that the correct diagnosis was made, as possibly spongious bone was seen in the corpus sphenoidale instead of aeration.
Contrast-enhanced magnetic resonance imaging (MRI) of the brain demonstrated enhancement of the dura along the planum sphenoidale
, the anterior frontal lobes bilaterally, and the orbital apices bilaterally (figure 1).