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. 2024 Mar 16;166(1):140.
doi: 10.1007/s00701-024-06033-x.

Factors influencing postoperative visual improvement in 208 patients with tuberculum sellae meningiomas

Chengcheng Duan #  1   2 , Dengpan Song #  1   2 , Fang Wang  1   2 , Youjun Wang  1   2 , Mingkun Wei  1   2 , Junhao Fang  1   2 , Tingting Zhai  1   2 , Yuan An  1   2 , Yuchao Zuo  1   2 , Yan Hu  1   2 , Guihong Li  1   2 , Zhiyun Yu  1   2 , Fuyou Guo  3   4
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Factors influencing postoperative visual improvement in 208 patients with tuberculum sellae meningiomas

Chengcheng Duan et al. Acta Neurochir (Wien). .

Abstract

Objective: Tuberculum sellae meningiomas (TSMs) usually compress the optic nerve and optic chiasma, thus affecting vision. Surgery is an effective means to remove tumors and improve visual outcomes. On a larger scale, this study attempted to further explore and confirm the factors related to postoperative visual outcomes to guide the treatment of TSMs.

Methods: Data were obtained from 208 patients with TSMs who underwent surgery at our institution between January 2010 and August 2022. Demographics, ophthalmologic examination results, imaging data, extent of resection, radiotherapy status, and surgical approaches were included in the analysis. Univariate and multivariate logistic regressions were used to assess the factors that could lead to favorable visual outcomes.

Results: The median follow-up duration was 63 months, and gross total resection (GTR) was achieved in 174 (83.7%) patients. According to our multivariate logistic regression analysis, age < 60 years (odds ratio [OR] = 0.310; P = 0.007), duration of preoperative visual symptoms (DPVS) < 10 months (OR = 0.495; P = 0.039), tumor size ≤ 27 mm (OR = 0.337; P = 0.002), GTR (OR = 3.834; P = 0.006), and a tumor vertical-to-horizontal dimensional ratio < 1 (OR = 2.593; P = 0.006) were found to be significant independent predictors of favorable visual outcomes.

Conclusion: Age, DPVS, tumor size, GTR, and the tumor vertical-to-horizontal dimensional ratio were found to be powerful predictors of favorable visual outcomes. This study may help guide decisions regarding the treatment of TSMs.

Keywords: Complications; Extent of resection; Transcranial approaches; Tuberculum sellae meningiomas; Visual outcomes.

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