Microsurgical removal of suprasellar meningiomas.

The authors report 17 cases of large suprasellar meningiomas operated on during the 2-year period from February 1982 through March 1984. The tumors ranged from 4 to 9 cm in diameter. These patients presented with severe visual loss (4 were blind) and optic atrophy or papilledema. These tumors were noteworthy in their encroachment against and around the carotid arteries and optic nerves laterally, as well as against the hypothalamus with extension into the interpeduncular cistern and frontal fossa. Advanced microsurgical technique assisted in total removal of all tumor tissue with preservation of vital structures. There were three deaths: two from pulmonary embolism and one from gastrointestinal hemorrhage. The surgical technique for the total removal of these very large tumors is described.