ArticleNeurosurgery2023
International Tuberculum Sellae Meningioma Study: Surgical Outcomes and Management Trends.
Article in Neurosurgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Postoperative CSF Characteristics After Extended Endoscopic Skull Base Surgery: Case Series and Review of the Literature.Journal of neurological surgery. Part B, Skull base · 2026Article
- Declining age-adjusted surgical incidence of intracranial meningiomas: a 19-year retrospective analysis from an academic hospital.Journal of neuro-oncology · 2026Article
- Midterm Outcomes of the Endoscopic Endonasal Approach for Treating Tuberculum Sellae Meningiomas: The Impact of Malleable Forceps and Predictors of Surgical Success.Journal of neurological surgery. Part B, Skull base · 2026Article
- Visual outcomes following endoscopic endonasal approach for tuberculum sellae meningiomas a systematic review and meta-analysis.International journal of surgery (London, England) · 2026Article
- Surgical strategy to minimize dominant hemisphere retraction in an asymmetric giant tuberculum sellae meningioma with contralateral anterior cerebral artery positioning: A case report.Surgical neurology international · 2026Article
- Neuroendoscopic single-nostril nasoseptal approach for tuberculum sellae meningiomas: technical description and preliminary clinical experience.Frontiers in neurology · 2026Article
- Effect of routine extradural optic canal decompression performed by skull base trained surgeons on visual outcomes in patients with anterior skull base meningiomas.Acta neurochirurgica · 2025Article
- Important role of endoscope in tuberculum sellae meningioma resection via supraorbital keyhole approach.Acta neurochirurgica · 2025Article
- Supraorbital keyhole approach (SOKHA) versus endoscopic endonasal approach (EEA) for suprasellar meningioma (SSM) resection: systematic review and meta-analysis.Annals of medicine and surgery (2012) · 2025Review
- Fully endoscopic combined endonasal and supraorbital keyhole approach for tuberculum sellae meningiomas with marked lateral extension: How I do it.Acta neurochirurgica · 2025Article
- A case of endoscopic endonasal surgery for a tuberculum sellae meningioma resected in the third trimester of pregnancy.Surgical neurology international · 2025Article
- Meningioma: International Consortium on Meningiomas consensus review on scientific advances and treatment paradigms for clinicians, researchers, and patients.Neuro-oncology · 2024Review
- Factors influencing postoperative visual improvement in 208 patients with tuberculum sellae meningiomas.Acta neurochirurgica · 2024Article
- Surgical treatment of tuberculum sellae meningioma: A retrospective review of single institutional experience.Surgical neurology international · 2024Article
- Skull Base Registries: A Roadmap.Journal of neurological surgery. Part B, Skull base · 2022Review
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Authors and funding
11 authors.
Funding
Abstract
BACKGROUND AND
objectivesTuberculum sellae meningiomas (TSMs) can be resected through transcranial (TCA) or expanded endonasal approach (EEA). The objective of this study was to report TSM management trends and outcomes in a large multicenter cohort.
methodsThis is a 40-site retrospective study using standard statistical methods.
resultsIn 947 cases, TCA was used 66.4% and EEA 33.6%. The median maximum diameter was 2.5 cm for TCA and 2.1 cm for EEA ( P < .0001). The median follow-up was 26 months. Gross total resection (GTR) was achieved in 70.2% and did not differ between EEA and TCA ( P = .5395). Vision was the same or better in 87.5%. Vision improved in 73.0% of EEA patients with preoperative visual deficits compared with 57.1% of TCA patients ( P < .0001). On multivariate analysis, a TCA (odds ratio [OR] 1.78, P = .0258) was associated with vision worsening, while GTR was protective (OR 0.37, P < .0001). GTR decreased with increased diameter (OR: 0.80 per cm, P = .0036) and preoperative visual deficits (OR 0.56, P = .0075). Mortality was 0.5%. Complications occurred in 23.9%. New unilateral or bilateral blindness occurred in 3.3% and 0.4%, respectively. The cerebrospinal fluid leak rate was 17.3% for EEA and 2.2% for TCA (OR 9.1, P < .0001). The recurrence rate was 10.9% (n = 103). Longer follow-up (OR 1.01 per month, P < .0001), World Health Organization II/III (OR 2.20, P = .0262), and GTR (OR: 0.33, P < .0001) were associated with recurrence. The recurrence rate after GTR was lower after EEA compared with TCA (OR 0.33, P = .0027).
conclusionEEA for appropriately selected TSM may lead to better visual outcomes and decreased recurrence rates after GTR, but cerebrospinal fluid leak rates are high, and longer follow-up is needed. Tumors were smaller in the EEA group, and follow-up was shorter, reflecting selection, and observation bias. Nevertheless, EEA may be superior to TCA for appropriately selected TSM.
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