{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:02:07Z","timestamp":1787025727249,"version":"build-2736575974"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,10]]},"abstract":"\n Object<\/jats:title>\n Various surgical approaches, such as uni- and bifrontal, frontolateral, and pterional approaches, have been advocated for tuberculum sellae meningiomas. The authors retrospectively reviewed the effectiveness of a bilateral subfrontal approach for tuberculum sellae meningiomas with special attention to ophthalmological outcomes and complications.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Between 1993 and 2009, 34 patients underwent surgery for removal of tuberculum sellae meningiomas at Osaka City University. Tumor size ranged from 14 to 45 mm. Thirty-two of 34 patients presented with visual disturbances before the surgery. The visual functions in all patients were assessed using a visual impairment score (VIS) before and after surgery. Postoperative visual examination was performed 2 weeks after surgery. Long-term follow-up examinations were conducted 1 year after surgery.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Radical resection (Simpson Grades I and II) was accomplished in 27 patients, and subtotal or partial resection (Simpson Grades III and IV) was achieved in 7. There was no deterioration in postoperative visual outcome. Twenty-nine (90.6%) of 32 patients showed improved VIS compared with preoperative VIS. The average VIS was 38.1 preoperatively, 23.5 in the short-term postoperative period, and 21.8 in the long-term postoperative period. In the short-term postoperative period, the visual function in 6 patients normalized, and visual problems persisted in the remaining 26. Six (23%) of 26 patients showed further improvement in VIS during the long-term follow-up period, and no patient exhibited a worsened VIS during this time. One patient complained of hyposmia after surgery, but there was no indication of related complications such as CSF leakage or frontal brain contusion.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The bilateral subfrontal approach was previously avoided because of the relatively high rate of complications in earlier surgical series of tuberculum sellae meningiomas. However, after developments in microsurgical techniques in recent years, the bilateral subfrontal approach can now provide satisfactory visual outcomes with minimal postoperative complications. Careful preservation of the blood supply to optic apparatus and early unroofing of the optic canal using a bilateral subfrontal approach led to further improvement in long-term postoperative visual outcome.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2011.5.jns101812","type":"journal-article","created":{"date-parts":[[2011,7,8]],"date-time":"2011-07-08T16:26:46Z","timestamp":1310142406000},"page":"802-810","source":"Crossref","is-referenced-by-count":56,"title":["Bilateral subfrontal approach for tuberculum sellae meningiomas in long-term postoperative visual outcome"],"prefix":"10.3171","volume":"115","author":[{"given":"Isao","family":"Chokyu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeo","family":"Goto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Ishibashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Nagata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Ohata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns101812","series-title":"Meningiomas","first-page":"395","article-title":"Tuberculum sellae meningiomas","author":"Al-Mefty","year":"1991"},{"key":"b2-jns101812","series-title":"Acta Neurochir (Wien)","first-page":"751","article-title":"Transcranial transsphenoidal approach for tuberculum sellae meningiomas","volume":"142","author":"Arai","year":"2000"},{"issue":"2 Suppl","key":"b3-jns101812","series-title":"Neurosurgery","first-page":"411","article-title":"The microsurgical nuances of resecting tuberculum sellae meningiomas","volume":"56","author":"Benjamin","year":"2005"},{"key":"b4-jns101812","series-title":"J Neurosurg","first-page":"327","article-title":"The arterial supply of the human optic chiasm","volume":"31","author":"Bergland","year":"1969"},{"issue":"1","key":"b5-jns101812","series-title":"Neurosurg Focus","first-page":"e4","article-title":"Cerebrospinal fluid leaks following spinal or posterior fossa surgery: use of fat grafts for prevention and repair","volume":"9","author":"Black","year":"2000"},{"key":"b6-jns101812","series-title":"Otolaryngol Head Neck Surg","first-page":"363","article-title":"Anterior table free bone graft technique for frontal sinus obliteration","volume":"106","author":"Casiano","year":"1992"},{"key":"b7-jns101812","series-title":"J Neuroophthalmol","first-page":"3","article-title":"Visual outcome in surgically treated suprasellar meningiomas","volume":"23","author":"Chicani","year":"2003"},{"key":"b8-jns101812","series-title":"Meningiomas. Their Classification, Regional Behaviour, Life History, and Surgical End Results","first-page":"224","author":"Cushing","year":"1938"},{"key":"b9-jns101812","series-title":"J Neurosurg","first-page":"235","article-title":"Pterional surgery of meningiomas of the tuberculum sellae and planum sphenoidale: surgical results with special consideration of ophthalmological and endocrinological outcomes","volume":"96","author":"Fahlbusch","year":"2002"},{"key":"b10-jns101812","series-title":"Neurosurgery","first-page":"1358","article-title":"Tuberculum sellae meningioma: a report on management on the basis of a surgical experience with 70 patients","volume":"51","author":"Goel","year":"2002"},{"key":"b11-jns101812","series-title":"Neurosurg Rev","first-page":"111","article-title":"Meningiomas of the tuberculum sella","volume":"16","author":"G\u00f6kalp","year":"1993"},{"key":"b12-jns101812","series-title":"Neurosurgery","first-page":"1432","article-title":"Tuberculum sellae meningiomas: microsurgical anatomy and surgical technique","volume":"51","author":"Jallo","year":"2002"},{"key":"b13-jns101812","series-title":"Am J Ophthalmol","first-page":"689","article-title":"Longterm visual outcome after nonradical microsurgery in patients with parasellar and cavernous sinus meningiomas","volume":"130","author":"Klink","year":"2000"},{"key":"b14-jns101812","series-title":"AJNR Am J Neuroradiol","first-page":"1721","article-title":"MR evaluation of frontal sinus osteoplastic flaps with autogenous fat grafts","volume":"16","author":"Loevner","year":"1995"},{"key":"b15-jns101812","series-title":"Neurosurgery","first-page":"570","article-title":"Visual outcome of tuberculum sellae meningiomas after extradural optic nerve decompression","volume":"59","author":"Mathiesen","year":"2006"},{"key":"b16-jns101812","series-title":"Laryngoscope","first-page":"1495","article-title":"Outcome of frontal sinus obliteration","volume":"109","author":"Mendians","year":"1999"},{"key":"b17-jns101812","series-title":"AJNR Am J Neuroradiol","first-page":"733","article-title":"\u2018Leave me alone\u2019 lesions of the petrous apex","volume":"19","author":"Moore","year":"1998"},{"key":"b18-jns101812","series-title":"Neurosurgery","first-page":"1019","article-title":"Tuberculum sellae meningiomas: clinical outcome considering different surgical approaches","volume":"59","author":"Nakamura","year":"2006"},{"key":"b19-jns101812","series-title":"Acta Neurochir (Wien)","first-page":"1121","article-title":"Outcome determinants of pterional surgery for tuberculum sellae meningiomas","volume":"147","author":"Pamir","year":"2005"},{"key":"b20-jns101812","series-title":"Neurosurgery","first-page":"238","article-title":"Surgically treated tuberculum sellae and diaphragm sellae meningiomas: the importance of short-term visual outcome","volume":"59","author":"Park","year":"2006"},{"key":"b21-jns101812","series-title":"J Neurosurg","first-page":"180","article-title":"Intracranial hypophysectomy","volume":"28","author":"Ray","year":"1968"},{"key":"b22-jns101812","series-title":"J Neurol Neurosurg Psychiatry","first-page":"977","article-title":"Surgical management of tuberculum sellae meningiomas: involvement of the optic canal and visual outcome","volume":"76","author":"Schick","year":"2005"},{"key":"b23-jns101812","series-title":"J Neurol Neurosurg Psychiatry","first-page":"22","article-title":"The recurrence of intracranial meningiomas after surgical treatment","volume":"20","author":"Simpson","year":"1957"},{"key":"b24-jns101812","series-title":"Acta Neurochir (Wien)","first-page":"181","article-title":"Suprasellar and olfactory meningiomas. 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Part 1: The influence of tumor size, duration of symptoms, and microsurgery on surgical outcome in 101 consecutive cases","volume":"61","author":"Symon","year":"1984"},{"key":"b26-jns101812","series-title":"Laryngoscope","first-page":"1037","article-title":"Osteoplastic frontal sinus surgery with fat obliteration: technique and long-term results using magnetic resonance imaging in 82 operations","volume":"110","author":"Weber","year":"2000"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/115\/4\/article-p802.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/115\/4\/article-p802.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/115\/4\/article-p802.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T22:06:50Z","timestamp":1679868410000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/115\/4\/article-p802.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2011,10]]},"references-count":26,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2011.5.jns101812","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,10]]}}}