{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:00:10Z","timestamp":1791979210836,"version":"4.4.0"},"reference-count":50,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>Following the introduction of the neurosurgical microscope, the outcomes in suprasellar meningioma surgery were dramatically improved. More recently, the neurosurgical endoscope has been introduced as a visualization option during removal of skull base tumors, both transcranially and endonasally. The authors retrospectively reviewed the effectiveness of endoscopic endonasal surgery (EES) in the management of suprasellar meningiomas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between 2002 and 2011, 75 patients (81.3% female) with suprasellar meningiomas underwent EES at the University of Pittsburgh Medical Center. The authors present the results of EES and analyze the resection rates, visual outcome, and complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventy-one patients presented with primary tumors, whereas 4 were previously treated elsewhere. Their mean age was 57.3 years (range 36\u201388 years), and most patients presented with visual loss (81.3%). Tumors occupied the tuberculum sellae (86.7%) and planum sphenoidale (50.7%), with extension into the optic canals in 26.7% (unilateral in 21.3% and bilateral in 5.3%) and the pituitary fossa (9.3%). Gross-total tumor resection (Simpson Grade I) was achieved in 76% of the cases in the whole cohort and in 81.4% of the patients in whom it was the goal of surgery. Tumor location and extension into the optic canals was not a limitation for total resection. Tumor size, configuration, and vascular encasement were significant factors that influenced the degree of resection (p &lt; 0.0001). Vision was improved or normalized in 85.7% of the cases. Visual deterioration following EES occurred in 2 patients (3.6%). Complications included postoperative CSF leaks (25.3% overall, 16.1% in recent years) resulting in meningitis in 4 cases. One patient had an intraoperative injury of the artery of Heubner resulting in associated neurological deficit. Another elderly patient died within 1 month after EES due to cerebral vasospasm and multisystem impairment. No patient developed postoperative cerebral contusions, hemorrhage, or seizures. During a mean follow-up period of 29 months (range 1\u201398 months), 4 patients have shown recurrence, but only 1 required repeat EES.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>With the goal of gross-total tumor resection and visual improvement, EES can achieve very good results, (comparable to microscopic approaches) for the treatment of suprasellar meningiomas. Avoidance of brain and optic nerve retraction, preservation of the vascularization of the optic apparatus, and wide decompression of the optic canals are the main advantages of EES for the treatment of suprasellar meningiomas, while CSF leaks remain a disadvantage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2014.2.jns13767","type":"journal-article","created":{"date-parts":[[2014,3,28]],"date-time":"2014-03-28T19:02:11Z","timestamp":1396033331000},"page":"1326-1339","source":"Crossref","is-referenced-by-count":155,"title":["Endoscopic endonasal surgery for suprasellar meningiomas: experience with 75 patients"],"prefix":"10.3171","volume":"120","author":[{"given":"Maria","family":"Koutourousiou","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan C.","family":"Fernandez-Miranda","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Tonya","family":"Stefko","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"},{"name":"Ophthalmology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric W.","family":"Wang","sequence":"additional","affiliation":[{"name":"Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl H.","family":"Snyderman","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"},{"name":"Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns13767","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1227\/00006123-198503000-00014","article-title":"Microsurgical removal of suprasellar meningiomas","volume":"16","author":"Al-Mefty","year":"1985"},{"key":"b2-jns13767","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1007\/s007010070089","article-title":"Transcranial transsphenoidal approach for tuberculum sellae meningiomas","volume":"142","author":"Arai","year":"2000"},{"issue":"1 Suppl Operative","key":"b3-jns13767","series-title":"Neurosurgery","first-page":"58","article-title":"The importance and timing of optic canal exploration and decompression during endoscopic endonasal resection of tuberculum sella and planum sphenoidale meningiomas","volume":"71","author":"Attia","year":"2012"},{"key":"b4-jns13767","series-title":"Atlas of Neurosurgical Techniques","first-page":"608","article-title":"Olfactory groove and planum sphenoidale meningiomas","author":"Bogaev","year":"2006"},{"key":"b5-jns13767","series-title":"Adv Tech Stand Neurosurg","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1007\/978-3-211-72283-1_4","article-title":"Extended endoscopic endonasal approach to the midline skull base: the evolving role of transsphenoidal surgery","volume":"33","author":"Cappabianca","year":"2008"},{"key":"b6-jns13767","series-title":"Endoscopic Approaches to the Skull Base. 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