The dissertation was performed on the basis of the results of surgical treatment 137 patients with around sellar meningiomas (ASM). Patients were on treated in the "Institute of Neurosurgery named after. acad. AP Romodanova NAMS of Ukraine" from 01/01/2010 to 31/12/2015. ASM included: meningiomas of tuberculum sella - 26 (19,0%), the small sphenoidal wing meningiomas -50 (36,5%), meningiomas of the medial part of great sphenoidal wing and lateral wall of the cavernous sinus - 61 (44,5%).
The aim of the study was to increase the effectiveness of treatment for patients with ASM by optimizing their diagnosis and surgical removal techniques.
Taking into account the peculiarities of the growth of the meningioma of tuberculum sella, their spread, the relationship with the vessels, we carried out the removal of meningiomas with the use of subfrontal (24 cases) and FTOZ (2 cases). The Simpson I-II have been achieved in both patients with FTOZ. Among patients with subfrontal approach Simpson I-II was achived in 15 patients (62,5%).
The meningiomas of the small wing have been often removed after pterional approach in 23 cases and FTOZ in 23 cases. Much less often, the removal of the tumor was carried out from the subfrontal access – in 4 patients. Often, the radicals that corresponded to the I-II degree of the Simpson scale were achieved with the use of FTOZ access – in 14 patients (out of 23), less often with subfrontal – 2 patients (out of 4), and 10 accessions – 10 (out of 23).
In order to remove the meningioma of the large wing and the lateral wall of the cavernous sinus, we used the following approaches: pterional (48 cases) and FTOZ (13 cases). the Simpson I-II was achived in 4 cases from 13 with FTOZ and 10 from 48 with pterional approaches.
In 93 patients who were operated on with ASM in 36 patients (38,7%), there were no changes in 46 patients (49,5%), the deterioration occurred in 12 patients (36 patients) 11,8%). However, when comparing the results of treatment in patients with extradural and intradural optic nerve decompression (OND), significant differences were detected. Improvement of the visual function in the I clinical group occurred in 23 (58,9%) observations, whereas in the II clinical group, only 13 (24,1%). The changes were not found in 13 patients (33,4%) of I clinical group and 33 patients (59.3%) of II clinical group. The deterioration of the visual function was noted in 3 (7,7%) observations of І clinical group and in 9 (16,6%) of ІІ clinical group.
