{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T15:38:28Z","timestamp":1781710708764,"version":"3.54.5"},"reference-count":39,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The objective of this study was to evaluate the ophthalmological outcome, nonvisual morbidity, and surgical complications after tuberculum sellae meningioma (TSM) removal using a superior interhemispheric approach.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>In the last decade, 20 consecutive patients with TSM underwent operations using the superior interhemispheric approach. Visual acuity, visual field, and ocular fundus examination were assessed both preoperatively and 6-months postoperatively. Nonvisual morbidity was determined at an early postoperative period and at 6 months based on assessment of the Karnofsky Performance Scale score, leakage of CSF, endocrinological status, and olfactory function, which was assessed using a visual analog scale (VAS). The potential brain injury related to the approach was assessed by MRI at 6 months. Magnetic resonance imaging was then performed yearly to detect a recurrence. The mean follow up was 56.3 \u00b1 34 months.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The primary presenting symptom for diagnosis of TSM in 20 patients (female:male ratio of 6.6:1, mean age 59.1 \u00b1 11.1 years) was visual disturbance in 12 patients (60%), headache in 4 (20%), cognitive alteration in 1 (5%), epilepsy in 2 (10%), and accidental in 1 (5%). In a total of 40 eyes, 17 eyes in 11 patients presented with preoperative deterioration of visual acuity. Postoperatively, the visual acuity improved in 13 eyes in 8 patients (72.8%), remained unchanged in 3 eyes in 2 patients (18.2%) and deteriorated in 1 patient (9%). The nonvisual morbidity included olfactory deterioration in 7 patients (35%), and panhypopituitarism in 1 patient (5%). No patients experienced a CSF leak. The impact of olfactory deterioration on the quality of life, as estimated by a VAS score (range 0\u201310), was a mean of 5.7 \u00b1 2.2 (95% CI 4.1\u20137.3). On the follow-up MRI, no additional lesions or recurrences were observed on the medial aspect of the frontal lobe along the surgical corridor.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The superior interhemispheric approach appears to be effective in resolving the problem of visual deterioration due to a TSM, without inducing surgical injury on the brain surface along the surgical corridor. Olfactory deterioration remained the challenging predominant nonvisual morbidity using this approach.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2012.9.jns12167","type":"journal-article","created":{"date-parts":[[2012,10,12]],"date-time":"2012-10-12T14:06:18Z","timestamp":1350050778000},"page":"1013-1021","source":"Crossref","is-referenced-by-count":28,"title":["Validation of the superior interhemispheric approach for tuberculum sellae meningioma"],"prefix":"10.3171","volume":"117","author":[{"given":"Sophie","family":"Curey","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Derrey","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Hannequin","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Hannequin","sequence":"additional","affiliation":[{"name":"Neurology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Fr\u00e9ger","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Muraine","sequence":"additional","affiliation":[{"name":"Ophthalmology, Rouen University Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9l\u00e8ne","family":"Castel","sequence":"additional","affiliation":[{"name":"INSERM U982, Neuronal and Neuroendocrine Communication and Differentiation, Rouen University, Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Proust","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"INSERM U982, Neuronal and Neuroendocrine Communication and Differentiation, Rouen University, Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns12167","series-title":"J Neurosurg","first-page":"523","article-title":"Suprasellar meningiomas: the effect of tumor location on postoperative visual outcome","volume":"69","author":"Andrews","year":"1988"},{"key":"b2-jns12167","series-title":"Surg Neurol","first-page":"37","article-title":"Tuberculum sellae meningiomas: functional outcome in a consecutive series treated microsurgically","volume":"66","author":"Bassiouni","year":"2006"},{"key":"b3-jns12167","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 Suppl","key":"b4-jns12167","series-title":"Neurosurgery","first-page":"17","article-title":"Microsurgical anatomic features of the olfactory nerve: relevance to olfaction preservation in the pterional approach","volume":"57","author":"Cardali","year":"2005"},{"key":"b5-jns12167","series-title":"Surg Neurol","first-page":"315","article-title":"Distal anterior cerebral artery aneurysms: bifrontal basal anterior interhemispheric approach","volume":"64","author":"Chhabra","year":"2005"},{"issue":"4","key":"b6-jns12167","series-title":"Neurosurg Focus","first-page":"e6","article-title":"Tuberculum sellae meningiomas","volume":"14","author":"Chi","year":"2003"},{"key":"b7-jns12167","series-title":"Neurosurgery","first-page":"1372","article-title":"Suprasellar meningiomas","volume":"49","author":"Ciric","year":"2001"},{"key":"b8-jns12167","series-title":"J Craniofac Surg","first-page":"1080","article-title":"Microsurgical anatomy for intraoperative preservation of the olfactory bulb and tract","volume":"22","author":"C\u00f6mert","year":"2011"},{"key":"b9-jns12167","series-title":"Meningiomas: Their Classification, Regional Behaviour, Life History and Surgical Ends Results","first-page":"224","article-title":"Suprasellar meningiomas","year":"1938"},{"key":"b10-jns12167","series-title":"Neurosurgery","first-page":"1142","article-title":"Olfaction preservation in anterior cranial base approaches: an anatomic study","volume":"48","author":"Dare","year":"2001"},{"issue":"6 Suppl 3","key":"b11-jns12167","series-title":"Neurosurgery","first-page":"1233","article-title":"Frontobasal interhemispheric trans-lamina terminalis approach for suprasellar lesions","volume":"62","author":"Dehdashti","year":"2008"},{"key":"b12-jns12167","series-title":"Acta Neurochir (Wien)","first-page":"1197","article-title":"Validity of the frontolateral approach as a minimally invasive corridor for olfactory groove meningiomas","volume":"151","author":"El-Bahy","year":"2009"},{"key":"b13-jns12167","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":"b14-jns12167","series-title":"Surg Radiol Anat","first-page":"133","article-title":"Blood supply of the olfactory nerve. 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