Approach Selection for Planum Sphenoidale and Tuberculum Sellae Meningiomas

AbstractPurpose of ReviewTuberculum sellae (TS) and planum sphenoidale (PS) meningiomas are common lesions of anterior skull base posing a surgical challenge due to their proximity to the optic apparatus and vessels of the anterior circle of Willis.Recent FindingsTraditionally, these lesions were attacked surgically via large transcranial approaches. However, with the advent and evolution of expanded endoscopic endonasal approaches as well as development of the minimally invasive “eye-brow” approaches, different choices of approach became available for these lesions. Regardless, the wide, yet smooth spectrum of anatomical features of these tumors in relation to the adjacent neurovascular structures and osseous skull base anatomy may make one or more of these approaches s uperior to others with regard to ability to achieve gross total resection, clinical outcomes, and complication profile. Not surprisingly, there is considerable controversy in the literature regarding the choice of approach for these lesions.SummaryThis paper summarizes the historical evolution, relative advantages and disadvantages, and clinical outcomes of these approaches when used to resect TS/PS meningiomas and provide a simple decision-making algorithm for selection of surgical approach based on the current literature.

Source: Current Otorhinolaryngology Reports - October 7, 2023 Category: ENT & OMF Source Type: research