Diaphragma Sellae

2020 ◽  
Author(s):  
Keyword(s):  
Diaphragma Sellae

MICROSURGICAL ANATOMY OF THE DIAPHRAGMA SELLAE AND ITS ROLE IN DIRECTING THE PATTERN OF GROWTH OF PITUITARY ADENOMAS

Neurosurgery ◽  
2008 ◽  
Vol 62 (3) ◽  
pp. 717-723 ◽  
Author(s):  
Alvaro Campero ◽  
Carolina Martins ◽  
Alexandre Yasuda ◽  
Albert L. Rhoton
Keyword(s):  
Pituitary Adenoma ◽  
Cavernous Sinus ◽  
Dura Mater ◽  
Pituitary Adenomas ◽  
Potential Role ◽  
Pituitary Tumors ◽  
Microsurgical Anatomy ◽  
Suprasellar Region ◽  
Lateral Distance ◽  
Diaphragma Sellae

Abstract OBJECTIVE To evaluate the anatomic aspects of the diaphragma sellae and its potential role in directing the growth of a pituitary adenoma. METHODS Twenty cadaveric heads were dissected and measurements were taken at the level of the diaphragma sellae. RESULTS The diaphragma sellae is composed of two layers of dura mater. There is a remarkable variation in the morphology of the diaphragm opening. The average anteroposterior distance of the opening was 7.26 mm (range, 3.4–10.7 mm) and the average lateral-to-lateral distance was 7.33 mm (range, 2.8–14.1 mm). CONCLUSION The variability in the diameter of the opening of the diaphragma sellae could explain the growth of pituitary tumors toward the cavernous sinus or toward the suprasellar region.

Suprasellar meningiomas: the effect of tumor location on postoperative visual outcome

1988 ◽  
Vol 69 (4) ◽  
pp. 523-528 ◽  
Author(s):  
Brian T. Andrews ◽  
Charles B. Wilson
Keyword(s):  
Visual Loss ◽  
Visual Outcome ◽  
Tumor Location ◽  
Postoperative Recovery ◽  
Optic Canal ◽  
Visual Disability ◽  
Content Type ◽  
Tuberculum Sellae ◽  
Diaphragma Sellae ◽  
Planum Sphenoidale

✓ The authors reviewed 38 cases of suprasellar meningioma to determine the correlation between tumor site and postoperative visual outcome. Progressive visual loss, the most frequent initial complaint (94.7%), occurred over a mean of 24½ months, was most often unilateral (18 patients) or bilateral but asymmetrical (14 patients), and was severe (20/200 vision or worse) in 23 patients; 24 patients had visual field abnormalities. Computerized tomography or magnetic resonance studies clearly delineated the lesions but did not appear to permit earlier diagnosis. Eleven patients had tumors limited to the tuberculum sellae; the tumor extended from the tuberculum sellae onto the planum sphenoidale in nine patients, into one optic canal in eight, onto the diaphragma sellae in seven, and onto the medial sphenoid wing in three. Patients with tumors affecting the optic canal had severe unilateral visual loss more often than those with tumors at other sites. Tumors limited to the tuberculum sellae were most often completely resected; postoperative recovery of vision was also most frequent in patients with tumors at this site. Tumors involving the diaphragma sellae or the medial sphenoid wing were least often completely removed and most likely to be associated with postoperative visual deterioration. Overall, 42% of patients had improved vision postoperatively, 30% remained unchanged, and 28% were worse. After a mean follow-up period of 38 months, 24 patients are doing well, four have significant visual disability, and three are blind or doing poorly. Two patients died of causes unrelated to their tumor. Three patients have had tumor recurrence.

Intrasellar and Diaphragma Sellae Meningiomas

Meningiomas ◽  
2010 ◽  
pp. 407-411
Author(s):  
Chirag G. Patil ◽  
Edward R. Laws ◽  
John A. Jane
Keyword(s):  
Diaphragma Sellae

Extended Transsphenoidal Microsurgical Approach for Diaphragma Sellae and Tuberculum Meningiomas

2009 ◽  
Vol 52 (05/06) ◽  
pp. 267-270 ◽  
Author(s):  
M. F. Fraioli ◽  
L. Moschettoni ◽  
R. Floris ◽  
E. Catena ◽  
B. Fraioli
Keyword(s):  
Microsurgical Approach ◽  
Diaphragma Sellae

The empty sella and some related syndromes

1972 ◽  
Vol 36 (2) ◽  
pp. 162-168 ◽  
Author(s):  
Sixto Obrador
Keyword(s):  
Cerebrospinal Fluid ◽  
Subarachnoid Space ◽  
Empty Sella ◽  
Empty Sella Syndrome ◽  
Content Type ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Pituitary Glands ◽  
Diaphragma Sellae ◽  
Fine Print ◽  
Syndrome Association

✓ A case of empty sella syndrome due to a benign intrasellar cyst leads the author to a review of variations in this syndrome. Association with intrasellar diverticuli of the subarachnoid space, deficiencies of the diaphragma sellae, and small pituitary glands are identified. Its relationship with certain headaches in women and to unexplained nontraumatic cerebrospinal fluid rhinorrhea are discussed.

scholarly journals Technical nuances in the management of tuberculum sellae and diaphragma sellae meningiomas

2013 ◽  
Vol 35 (6) ◽  
pp. E7 ◽  
Author(s):  
Anil Nanda ◽  
Sudheer Ambekar ◽  
Vijayakumar Javalkar ◽  
Mayur Sharma
Keyword(s):  
Visual Outcome ◽  
Surgical Excision ◽  
Visual Improvement ◽  
Microsurgical Techniques ◽  
Technical Details ◽  
Tuberculum Sellae ◽  
Vascular Structures ◽  
Diaphragma Sellae ◽  
Neurovascular Structures

Object Tuberculum sellae meningiomas (TSMs) and diaphragma sellae meningiomas (DSMs) are challenging lesions to treat due to their proximity to neurovascular structures. Methods The authors reviewed the medical records of patients who underwent surgical excision of TSMs and DSMs from 1990 to 2013. They also describe the technical strategies used to minimize injury to the optic apparatus, vascular structures, and pituitary stalk. Results Twenty-four patients with TSM and 6 patients with DSM were included in the study. Seventy percent of the tumors were large (≥ 5 cm). The pterional approach was employed in most cases. Optic canal involvement was observed in 4 patients. Twenty-one patients (70%) had visual dysfunction before surgery. At follow-up (median 18 months), visual improvement was noted in 10 (47.6%) of 21 patients. Gross-total excision was achieved in 22 patients (91.6%) with TSM and 5 (83.3%) with DSM. At last follow-up, 28 patients (93.3%) had a Glasgow Outcome Scale score of 5. There were no deaths in this series. Conclusions Tuberculum and diaphragma sellae meningiomas present a unique subset of tumors due to their location. They can be safely excised with minimal morbidity and mortality using microsurgical techniques. Attention to technical details during surgery leads to greater respectability and superior visual outcome.

Retraction system for transsphenoidal surgery

1985 ◽  
Vol 62 (2) ◽  
pp. 307-309 ◽  
Author(s):  
Shigeaki Kobayashi ◽  
Kenichiro Sugita ◽  
Toshiki Takemae ◽  
Yoshio Tanizaki
Keyword(s):  
Transsphenoidal Surgery ◽  
The Self ◽  
Venous Sinus ◽  
Content Type ◽  
Tumor Bed ◽  
Tumor Tissues ◽  
Dural Venous Sinus ◽  
Diaphragma Sellae ◽  
Fine Print

✓ A retraction system has been developed for transsphenoidal surgery to use together with a conventional self-retaining speculum. The system comprises an attachment to the speculum, a self-retaining retractor, and a slim tapered brain spatula and pronged hook. The spatula or hook is secured with the self-retaining retractor and the attachment. The retractor can also be fixed to the Sugita multipurpose head frame. The system may be used to retract the bulging diaphragma sellae and tumor tissues, and to stop bleeding from the dural venous sinus or tumor bed, so the surgeon can continue the procedure with both hands.

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