{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T18:04:08Z","timestamp":1786125848418,"version":"build-2736575974"},"reference-count":2,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T00:00:00Z","timestamp":1620950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"abstract":"Abstract<\/jats:title>\n \n As described by Cushing\n 1<\/jats:sup>\n in the chiasmatic syndrome, tuberculum sellae meningiomas induce progressive asymmetrical, incongruous visual loss, which would lead to blindness. The surgical removal of these lesions has been rewarding in regard to visual preservation, or recovery, and has passed the test of time. Optic canal extension, in one or both canals, is a consistent feature of these tumors, and removing the tumor from the optic canals is paramount in the treatment of these lesions.\n 2<\/jats:sup>\n Despite the small target volume, radiosurgery is not applicable because of the lack of safe distance from the optic pathways. Tuberculum sella meningioma has been distinguished with good surgical outcomes and low recurrence rates; thus, Simpson grade I removal (tumor, dura, and bone invasion) confers a prospect of cure.\n <\/jats:p>\n \n \u2003Safe and successful resection of tuberculum meningiomas is achieved through the skull base supraorbital approach\n 3<\/jats:sup>\n with several critical objectives: (1) visualization of the tumor without brain retraction; (2) 270\u00b0 opening of the optic canal proximally and distally for safe tumor removal; (3) preservation of the vascular supply to the optic pathways and pituitary; (4) microsurgical dissection under high magnification on a short working distance to the encased carotid and anterior cerebral arteries; (5) complete resection of involved dura and bone at the skull base, particularly laterally; and (6) a robust skull base reconstruction with a vascularized pericranial flap.\n 4<\/jats:sup>\n <\/jats:p>\n \u2003We present the case of a 45-yr-old female with a tuberculum sella meningioma who underwent Simpson grade I removal with an uneventful outcome. The patient consented for surgery.<\/jats:p>\n \n \u2003Image at 2:59 reprinted with permission from Al-Mefty O,\n Operative Atlas of Meningiomas<\/jats:italic>\n . Vol 1, \u00a9 LWW, 1998; Image at 9:33 public domain.\n 4<\/jats:sup>\n <\/jats:p>","DOI":"10.1093\/ons\/opab133","type":"journal-article","created":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T16:38:21Z","timestamp":1621010301000},"page":"E103-E104","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Simpson Grade I Removal of Tuberculum Sella Meningioma Through the Supraorbital Approach: 2-Dimensional Operative Video"],"prefix":"10.1227","volume":"21","author":[{"given":"Michael A","family":"Mooney","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4640-0563","authenticated-orcid":false,"given":"Walid","family":"Ibn Essayed","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ossama","family":"Al-Mefty","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,8]]},"reference":[{"issue":"3 Suppl Operative","key":"bib2-20250821","first-page":"ons108","article-title":"Optic canal involvement in tuberculum sellae meningiomas: influence on approach, recurrence, and visual recovery","volume":"67","author":"Mahmoud","year":"2010","journal-title":"Neurosurgery"},{"issue":"4","key":"bib3-20250821","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1097\/00006123-198210000-00016","article-title":"The supraorbital approach: technical note","volume":"11","author":"Jane","year":"1982","journal-title":"Neurosurgery"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/article-pdf\/21\/2\/E103\/38923571\/opab133.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opab133","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:03:11Z","timestamp":1786122191000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opab133"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,14]]},"references-count":2,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opab133","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,14]]},"assertion":[{"value":"2020-12-23","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-23","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}