Suprasellar Meningiomas: The Visual Outcome

Abstract Background: Suprasellar meningiomas represent a unique set of surgical challenges due to their three-dimensional relationship with the optic apparatus, critical vasculature, and the pituitary stalk. These challenges are encountered with the context of a surgical goal that provides long-term tumor control, preservation or improvement of visual function and minimal morbidity. Aim of Study: In this study, we reviewed the literature retrospectively to evaluate the symptoms, clinical manifesta-tions, investigations and the surgical approach for suprasellar meningioma (SSM) to achieve the best visual outcome. Patients and Methods: This is a retrospective study of 25 cases of suprasellar meningioma, operated by trans cranial (combined pterional and sub frontal approaches) within the period between 2019 and 2022 in Bani Suef University Hos-pitals and Kasr El-Aini Hospitals. Neurological and visual examinations, radiological studies, hormonal assessment and follow-up were reviewed. Result: Our study included 9 males (36%) and 16 females (64%). The mean age was 42.28 years. The side of visual affection within the left eye was in 11 patients (44%), right eye was in 9 patients (36%) and bilateral visual affection was seen in 5 patients (20%). Hormonal profile assessment showed a decrease in T3 & T4 in 2 patients (8%), was normal in 22 patients (88%) and only one patient had a decrease of cortisol (4%). The opposite symptoms were headache in 25 cases (100%), vomiting in 5 cases (20%), and left sided weakness in 1 case (4%). Conclusion: Transcranial surgical excision through pteri-onal and/or subfrontal approaches is efficient within the management of suprasellar meningioma and is related to visual improvement and good visual outcome in most of cases with accepted percentage of postoperative complications.