Outcome of Sellar and Suprasellar Brain Tumors with Retractorless Modified Subfrontal Approach

Abstract

Aim: To determine the outcome of sellar and suprasellar brain tumors with retractorless modified subfrontal approach. Study design: Descriptive/observational study Place and duration of study: Department of Neurosurgery, Liaquat University Hospital Hyderabad/Jamshoro from 1st March 2020 to 28th February 2021. Methodology: Fifty patients of sellar and suprasellar brain tumors age between 15-70 years were enrolled. Patients details demographics age, sex and body mass index were recorded after taking written consent. The inter-hemispheric front-basal technique was used for all patients and the average follow-up time was 6 months. Postoperatively, magnetic resonance imaging (MRI) and computerized tomography (CT) scans in all patients were performed. After 12 hours, the postoperative CT scan was performed to monitor for persistent tumor and hemorrhage cerebral edema following an operation. Results: There were 30 (60%) male patients and 20 (40%) female patients. Mean age of the patients were 28.36±14.88 years with mean BMI 23.16±7.54 kg/m2. Most of the patients 20(40%) were from age group 15-30 years, followed by 31-40 years in 12 (24%) patients. Frequency of pituitary adenoma was found in 22 (44%) cases, craniopharyngioma found in 19 (38.7%) cases, arachnoid cyst found in 4 (8%), keratin flakes in 2 (4%) cases, benign giant cell tumor found in 2 (4%)olfactory groove meningioma in 1 (2%) and epidermoid in 1 (2%) cases. Post operatively 35 (70%) patients were completely recovered, complications found in 13 (26%) patients who were recovered later and frequency of not recovered patients was 2 (4%). According to Karnofsky performance, 16 (32%) patients had scale 30, scale 60 was in 2 (4%) cases, scale 70 in 4 (8%) patients, scale 80 in 19 (38%) and scale 90 in 9 (18%). Conclusion: This retractorless method is very effective and safe in the sellar and suprasellar region for excision of big tumors. This method allows the huge tumor to be removed without serious complication. Keywords: Sub-frontal approach, Sellar, Suprasellar, Brain tumor, Retractorless method