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Approach Selection for Planum Sphenoidale and Tuberculum Sellae Meningiomas

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Abstract

Purpose of Review

Tuberculum 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 Findings

Traditionally, 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 superior 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.

Summary

This 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.

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  1. Department of Neurosurgery, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 8100, Newark, NJ, 07103, USA

    Ali Tayebi Meybodi, Andrea L. Castillo & James K. Liu

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A.T.M.: conception and design, literature review, drafting manuscript, final review on behalf of all authors; A.C.L.: drafting manuscript, critical review of the manuscript; J.K.L.: conception and design, drafting manuscript, critical review of the manuscript, study supervison.

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Tayebi Meybodi, A., Castillo, A.L. & Liu, J.K. Approach Selection for Planum Sphenoidale and Tuberculum Sellae Meningiomas. Curr Otorhinolaryngol Rep 11, 437–451 (2023). https://doi.org/10.1007/s40136-023-00489-8

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