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KMID : 0359819960250020394
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Journal of Korean Neurosurgical Society
1996 Volume.25 No. 2 p.394 ~ p.402
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Postoperative Visual Results on Sellar and Parasellor Tumors
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조창성
하영일/김충현/송관영
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Abstract
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We reviewed the records of 28 patients who underwent transranial (20 cases) or transsphenoidal (8 cases) surgery for sellar and parasellar tumors.
Both pre-and postopertive visual status (visual acuity and field) of each eye were analyzed under the the rating system of Cohen. et. The average duration of follow-up 3 months. The lesions encountered consisted of pituitary adenoma in 14 cases.
craniopharyngioma in 5 cases. meningioma in 4 cases. chordoma in 3 cases. a dermoid cyst in 1 cases. and an unspecified tumor in another case.
All patients had objective signs of visual acuity or field defects preoperatively Overall postoperative visual acuity and visual fields were normalized or improved in 73% and 71% of the eyes. respectively. The visual outcome of postoperative
visual
acuity was better in cases of craniopharyngioma (80%) than the other tumors.
Visual evoked potentials (VEP) showed all postoperative improvement and was as helpful as visual fields in determining visual status.
The visual outcome was better in patients with a shorter duration of symptoms and those with smaller tumors Patients with lesser compromise of preoperative visual acuity head better outcome of postoperative visual acuity. However. the severity of
preoperative visual field defects did not seem to influence postoperative field outcome. There also was no relationship between the presence of endocrine activity of the tumor and visual outcome Patients who underwent transsphenoidal approach had
either
better visual acuity or field improvement than patients with transcranial approach.
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