How I do it: endoscopic endonasal resection of tuberculum sellae meningioma

Abstract

Background: Tuberculum sellae meningiomas (TSMs) adherent to neurovascular structures are particularly challenging lesions requiring delicate and precise microneurosurgery. There is an ongoing debate about the optimal surgical approach. Method: We describe technical nuances and challenges in TSM resection using the endoscopic endonasal approach (EEA) in two cases of fibrous tumors with adherence to neurovascular structures. The cases are illustrated with a video (case 1) and figures (cases 1 and 2). Conclusion: A dedicated team approach and precise microsurgical technique facilitate safe resection of complex TSMs through the EEA.