Intraoperative fat placement in surgically refractory parasellar neoplasms to facilitate stereotactic radiosurgery.

Abstract

In this article, we report on the technique of placing fat in between a sellar or parasellar neoplasm and the optic chiasm to possibly protect the optic chiasm from sequelae of radiation. A review was performed on three patients, each of whom had planned subtotal resection with fat placed near their optic chiasm to facilitate future radiosurgery. Follow-up on our three patients varied from 6 months to 3 years post-stereotactic radiosurgery. The fat remained stable and in place. The tumors either remained stable or reduced in size. No infections, postoperative marker dependent neurological complications or unusual symptoms were encountered. Placement of fat between a parasellar neoplasm and the optic chiasm appears to be a safe approach to help define the tumor chiasm space, helping to facilitate radiosurgery. Future experience is warranted to determine the efficacy of this technique.