Lateral Supraorbital Approach Versus Classic Pterional Approach In Suprasellar Meningiomas Regarding Accessibility and Safety

Abstract
Background: Minimally invasive Lateral Supraorbital Approach (LSO) is a modified classic pterional approach with advantages of a shorter skin incision and small craniotomy as compared with the pterional approach.
Aim of Study: To present our surgical experience in distinguishing between Lateral Supraorbital Approach [LSO] and conventional pterional approach regarding accessibility and safety in suprasellar meningioma.
Patients and Methods: This is a retrospective study of 19 cases who were diagnosed with suprasellarmeningiomas and were operated between March 2011 to March 2015 in Cairo University Hospital, and Beni-Sueif University Hospital. The patient was divided into two groups, group A (8 cases) operated via LSO, and group B (11 cases) managed via conventional pterional approach with follow-up period for one year the follow-up images were done immediately post-operative then every six months till 12 months.
Results: Complete resection was obtained in 7 cases (75%) in group A, while it was in 8 cases (72.6%) within group B, visual acuity improvement in group A was in 4 cases (50%), in group B it was in 6 cases (54%).
Vision unchanged in 3 cases (3 7.5%) group A, and in 4 cases (365%) group B.
Vision deteriorated in one case (12,5%) in group A, and in 1 case (9.5%) group B.
Transient diabetes insipidus was in only one case (9.5%) group B and no cases in group A.
Conclusion: LSO approach is safe, less invasive and provides same accessibility to suprasellarmeningiomas as compared to classic pterional approach.