Tuberculum sellae (TS) meningiomas represent a distinct subgroup of anterior cranial fossa meningiomas with distinctive features. Early visual deterioration with optic canal infiltration occurs because of the site of dural origin. The expanded endonasal transsphenoidal approach and the eyebrow supraorbital craniotomy have been advocated as minimally invasive techniques for TS meningiomas. The authors review the current literature on minimally invasive techniques for TS meningiomas to define visual outcomes, extent of resection, and operative morbidity associated with each approach and highlight pertinent features of individual tumors, which favor either a cranial or an endonasal approach to achieve optimal outcomes.
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