Watch @UCSFMedicalCenter neurosurgeon Manish Aghi, MD, PhD, remove a tuberculum sellae meningioma through an endoscopic endonasal approach.
The 51 year old female presented with headaches and left eye blurry vision for 3 days. MRI revealed a 19 x 17 x 21 mm tuberculum sella meningioma, with a postfixed optic chiasm and mass effect on the left optic nerve. The mass abutted the right supraclinoid internal carotid artery, and was closely associated with the left supraclinoid internal carotid artery which appeared to be mildly narrowed. The mass was amenable to an endoscopic endonasal approach based on a grading scale described at UCSF. With this minimally invasive technique, the tumor is removed entirely via the nasal passages.
Surgery was done as a co-surgery with UCSF otolaryngologist Ivan El-Sayed as part of the UCSF minimally invasive skull base surgery program founded by Drs. Aghi and El-Sayed in 2011. The mass had a firm texture but, with the aid of an ultrasonic aspirator, a gross total resection was achieved. The patient's left eye vision had recovered by the morning after surgery, and she went home on postoperative day 3.
