{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:05:38Z","timestamp":1780131938189,"version":"3.54.0"},"reference-count":104,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>This paper describes a consecutive series of skull base meningiomas resected using an endoscopic endonasal approach through various corridors at a single institution over 7 years. The impact of case selection and experience, the presence of a cortical cuff between the tumor and surrounding vessels, and brain edema on morbidity and rates of gross-total resection (GTR) were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of a series of 46 skull base meningiomas from a prospective database was conducted. The series of cases were divided by location: olfactory groove (n = 15), tuberculum and planum (n = 20), sellar\/cavernous (n = 9) and petroclival (n = 2). Gross-total resection was never intended in the sellar\/cavernous tumors, which generally invaded the cavernous sinus. Clinical charts, volumetric imaging, and pathology were reviewed to assess the extent of resection and complications. Cases were divided based on a time point in which surgical technique and case selection improved into Group 1 (surgery prior to June 2008; n = 21) and Group 2 (surgery after June 2008; n = 25) and into those with and without a cortical cuff and with and without brain edema.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Improved case selection had the greatest impact on extent of resection. For the entire cohort, rates of GTR went from 38% to 76% (p = 0.02), and for cases in which GTR was the intent, the rates went from 63% to 84% (not significant), which was mostly driven by the planum and tuberculum meningiomas, which went from 75% to 91.7 % (nonsignificant difference). The presence of a cortical cuff and brain edema had no impact on outcomes. There were 3 CSF leaks (6.5%) but all were in Group 1. Hence, CSF leak improved from 14.2% to 0% with surgical experience. Lessons learned for optimal case selection are discussed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Surgical outcome for endonasal endoscopic resection of skull base meningiomas depends mostly on careful case selection and surgical experience. Imaging criteria such as the presence of a cortical cuff or brain edema are less important.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2014.7.focus14321","type":"journal-article","created":{"date-parts":[[2014,10,1]],"date-time":"2014-10-01T04:43:47Z","timestamp":1412138627000},"page":"E7","source":"Crossref","is-referenced-by-count":31,"title":["Endoscopic endonasal resection of skull base meningiomas: the significance of a \u201ccortical cuff\u201d and brain edema compared with careful case selection and surgical experience in predicting morbidity and extent of resection"],"prefix":"10.3171","volume":"37","author":[{"given":"Osaama H.","family":"Khan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"M.Sc.","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay K.","family":"Anand","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore H.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"},{"name":"Department of Neurological Surgery"},{"name":"Neurology, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0370007","series-title":"Neurosurgery","first-page":"1398","article-title":"Analytical evaluation of complex anterior approaches to the cranial base: an anatomic study","volume":"43","author":"Ammirati","year":"1998"},{"issue":"1 Suppl Operative","key":"b2-0370007","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":"b3-0370007","series-title":"J Neurosurg","first-page":"654","article-title":"Giant anterior clinoidal meningiomas: surgical technique and outcomes. Clinical article","volume":"117","author":"Attia","year":"2012"},{"issue":"5","key":"b4-0370007","series-title":"Neurosurg Focus","first-page":"E1","article-title":"Surgical decision-making strategies in tuberculum sellae meningioma resection","volume":"30","author":"Bowers","year":"2011"},{"key":"b5-0370007","series-title":"J Neurosurg","first-page":"1","article-title":"Editorial. Craniopharyngiomas","volume":"109","author":"Cappabianca","year":"2008"},{"key":"b6-0370007","series-title":"J Neurosurg","first-page":"99","article-title":"Endoscopic endonasal transsphenoidal approach for pituitary adenomas invading the cavernous sinus","volume":"112","author":"Ceylan","year":"2010"},{"key":"b7-0370007","series-title":"Acta Neurochir (Wien)","first-page":"1","article-title":"Extended endoscopic transphenoidal approach for tuberculum sellae meningiomas","volume":"153","author":"Ceylan","year":"2011"},{"key":"b8-0370007","series-title":"Meningiomas: A Comprehensive Text","first-page":"373","article-title":"Olfactory groove meningiomas","author":"Coppens","year":"2010"},{"key":"b9-0370007","series-title":"Pituitary","first-page":"169","article-title":"Hypophysopexy technique for radiosurgical treatment of cavernous sinus pituitary adenoma","volume":"5","author":"Couldwell","year":"2002"},{"key":"b10-0370007","series-title":"Neurosurgery","first-page":"539","article-title":"Variations on the standard transsphenoidal approach to the sellar region, with emphasis on the extended approaches and parasellar approaches: surgical experience in 105 cases","volume":"55","author":"Couldwell","year":"2004"},{"issue":"6 Suppl 3","key":"b11-0370007","series-title":"Neurosurgery","first-page":"1192","article-title":"Extended endoscopic transsphenoidal approach for tuberculum sellae meningiomas","volume":"62","author":"de Divitiis","year":"2008"},{"key":"b12-0370007","series-title":"Neurosurgery","first-page":"556","article-title":"Tuberculum sellae meningiomas: high route or low route? A series of 51 consecutive cases","volume":"62","author":"de Divitiis","year":"2008"},{"key":"b13-0370007","series-title":"Neurosurgery","first-page":"677","article-title":"Expanded endoscopic endonasal approach for anterior cranial base and suprasellar lesions: indications and limitations","volume":"64","author":"Dehdashti","year":"2009"},{"key":"b14-0370007","series-title":"J Neurooncol","first-page":"239","article-title":"Surgical treatment of anterior basal meningiomas","volume":"29","author":"DeMonte","year":"1996"},{"issue":"5 Suppl 2","key":"b15-0370007","series-title":"Neurosurgery","first-page":"269","article-title":"Endonasal versus supraorbital keyhole removal of craniopharyngiomas and tuberculum sellae meningiomas","volume":"64","author":"Fatemi","year":"2009"},{"key":"b16-0370007","series-title":"Neurosurgery","first-page":"E260","article-title":"Endoscopic endonasal approach for tuberculum sellae meningiomas","volume":"69","author":"Fernandez-Miranda","year":"2011"},{"key":"b17-0370007","series-title":"Br J Neurosurg","first-page":"422","article-title":"Fronto-basal interhemispheric approach for tuberculum sellae meningiomas; long-term visual outcome","volume":"23","author":"Ganna","year":"2009"},{"key":"b18-0370007","series-title":"World Neurosurg","first-page":"563","article-title":"Gasket seal closure for extended endonasal endoscopic skull base surgery: efficacy in a large case series","volume":"80","author":"Garcia-Navarro","year":"2013"},{"key":"b19-0370007","series-title":"Neurosurgery","first-page":"36","article-title":"Endoscopic endonasal resection of anterior cranial base meningiomas","volume":"63","author":"Gardner","year":"2008"},{"key":"b20-0370007","series-title":"Neurosurgery","first-page":"883","article-title":"Endoscopic endonasal transethmoidal transcribriform transfovea ethmoidalis approach to the anterior cranial fossa and skull base","volume":"66","author":"Greenfield","year":"2010"},{"key":"b21-0370007","series-title":"Laryngoscope","first-page":"1882","article-title":"A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap","volume":"116","author":"Hadad","year":"2006"},{"issue":"6","key":"b22-0370007","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Olfactory groove meningiomas","volume":"14","author":"Hentschel","year":"2003"},{"key":"b23-0370007","series-title":"World Neurosurg","article-title":"Incidence and significance of intraoperative cerebrospinal fluid leak in endoscopic pituitary surgery using intrathecal fluorescein","author":"Jakimovski","year":"2013"},{"key":"b24-0370007","series-title":"Minim Invasive Neurosurg","first-page":"185","article-title":"Endoscopic glabellar approach to the anterior skull base: a technical note","volume":"45","author":"Jho","year":"2002"},{"key":"b25-0370007","series-title":"Neurosurgery","first-page":"94","article-title":"Transsphenoidal approaches for the extracapsular resection of midline suprasellar and anterior cranial base lesions","volume":"49","author":"Kaptain","year":"2001"},{"key":"b26-0370007","series-title":"J Neurosurg","first-page":"1544","article-title":"Endoscopic endonasal skull base surgery: analysis of complications in the authors\u2019 initial 800 patients. A review","volume":"114","author":"Kassam","year":"2011"},{"key":"b27-0370007","series-title":"Am J Surg","first-page":"591","article-title":"Complications of intracranial facial resection for tumors of the paranasal sinuses","volume":"112","author":"Ketcham","year":"1966"},{"key":"b28-0370007","series-title":"Am J Surg","first-page":"698","article-title":"A combined intracranial facial approach to the paranasal sinuses","volume":"106","author":"Ketcham","year":"1963"},{"key":"b29-0370007","series-title":"J Clin Neurosci","first-page":"927","article-title":"Pure endoscopic expanded endonasal approach for olfactory groove and tuberculum sellae meningiomas","volume":"21","author":"Khan","year":"2014"},{"key":"b30-0370007","series-title":"J Neurosurg","first-page":"999","article-title":"Extended transsphenoidal approach with submucosal posterior ethmoidectomy for parasellar tumors. Technical note","volume":"94","author":"Kitano","year":"2001"},{"key":"b31-0370007","series-title":"J Neurosurg","first-page":"337","article-title":"Postoperative improvement in visual function in patients with tuberculum sellae meningiomas: results of the extended transsphenoidal and transcranial approaches","volume":"107","author":"Kitano","year":"2007"},{"issue":"6","key":"b32-0370007","series-title":"Neurosurg Focus","first-page":"E6","article-title":"Endoscopic extended transsphenoidal resection of tuberculum sellae meningiomas: nuances of neurosurgical technique","volume":"35","author":"Kulwin","year":"2013"},{"key":"b33-0370007","series-title":"J Neurosurg","first-page":"400","article-title":"Endoscopic, endonasal extended transsphenoidal, transplanum transtuberculum approach for resection of suprasellar lesions","volume":"106","author":"Laufer","year":"2007"},{"issue":"1 Suppl 1","key":"b34-0370007","series-title":"Neurosurgery","first-page":"ONS108","article-title":"A surgical technique for the removal of clinoidal meningiomas","volume":"59","author":"Lee","year":"2006"},{"issue":"5 Suppl 2","key":"b35-0370007","series-title":"Neurosurgery","first-page":"ONSE342","article-title":"\u201cGasket-seal\u201d watertight closure in minimal-access endoscopic cranial base surgery","volume":"62","author":"Leng","year":"2008"},{"issue":"5","key":"b36-0370007","series-title":"Neurosurg Focus","first-page":"E11","article-title":"Hypophysial transposition (hypophysopexy) for radiosurgical treatment of pituitary tumors involving the cavernous sinus. Technical note","volume":"14","author":"Liu","year":"2003"},{"key":"b37-0370007","series-title":"World Neurosurg","article-title":"The transplanum transtuberculum approaches for suprasellar and sellar-suprasellar lesions: avoidance of cerebrospinal fluid leak and lessons learned","author":"Mascarenhas","year":"2013"},{"key":"b38-0370007","series-title":"J Neurosurg","first-page":"343","article-title":"Selective excision of adenomas originating in or extending into the pituitary stalk with preservation of pituitary function","volume":"87","author":"Mason","year":"1997"},{"key":"b39-0370007","series-title":"World Neurosurg","first-page":"136","article-title":"Long-term effectiveness of a reconstructive protocol using the nasoseptal flap after endoscopic skull base surgery","volume":"81","author":"McCoul","year":"2014"},{"key":"b40-0370007","series-title":"Neurosurgery","first-page":"1019","article-title":"Tuberculum sellae meningiomas: clinical outcome considering different surgical approaches","volume":"59","author":"Nakamura","year":"2006"},{"key":"b41-0370007","series-title":"Otolaryngol Head Neck Surg","first-page":"327","article-title":"Janus flap: bilateral nasoseptal flaps for anterior skull base reconstruction","volume":"142","author":"Nyquist","year":"2010"},{"key":"b42-0370007","series-title":"Acta Neurochir (Wien)","first-page":"621","article-title":"Extended transsphenoidal approach for tuberculum sellae meningioma\u2014what are the optimum and critical indications?","volume":"154","author":"Ogawa","year":"2012"},{"key":"b43-0370007","series-title":"World Neurosurg","article-title":"Endoscopic endonasal resection of suprasellar meningiomas: the importance of case selection and experience in determining extent of resection, visual improvement and complications","author":"Ottenhausen","year":"2014"},{"issue":"3 Suppl","key":"b44-0370007","series-title":"Neurosurgery","first-page":"161","article-title":"Safety of low-dose intrathecal fluorescein in endoscopic cranial base surgery","volume":"61","author":"Placantonakis","year":"2007"},{"key":"b45-0370007","series-title":"Neurosurgery","first-page":"991","article-title":"Endoscopic cranial base surgery: classification of operative approaches","volume":"62","author":"Schwartz","year":"2008"},{"key":"b46-0370007","series-title":"J Neurosurg","first-page":"198","article-title":"The extended frontal approach to tumors of the anterior, middle, and posterior skull base","volume":"76","author":"Sekhar","year":"1992"},{"key":"b47-0370007","series-title":"Otolaryngol Head Neck Surg","first-page":"316","article-title":"Intrathecal fluorescein in endoscopic skull base surgery","volume":"137","author":"Tabaee","year":"2007"},{"key":"b48-0370007","series-title":"J Neurosurg","first-page":"55","article-title":"Endocrinological outcome after pituitary transposition (hypophysopexy) and adjuvant radiotherapy for tumors involving the cavernous sinus. Clinical article","volume":"115","author":"Taussky","year":"2011"},{"issue":"5","key":"b49-0370007","series-title":"Neurosurg Focus","first-page":"E15","article-title":"Expanded endonasal endoscopic resection of anterior fossa meningiomas: report of 13 cases and meta-analysis of the literature","volume":"30","author":"Van Gompel","year":"2011"},{"key":"b50-0370007","series-title":"Surgery of the Third Ventricle","first-page":"476","article-title":"The transnasal transsphenoidal approach","author":"Weiss","year":"1987"},{"key":"b51-0370007","series-title":"Microneurosurgery: Operative Treatment of CNS Tumors","volume":"4B","author":"Ya\u015fargil","year":"1995"},{"key":"b52-0370007","series-title":"J Neurosurg","first-page":"286","article-title":"Defining the \u201cedge of the envelope\u201d: patient selection in treating complex sellar-based neoplasms via transsphenoidal versus open craniotomy. Clinical article","volume":"114","author":"Zada","year":"2011"},{"key":"b1-0370007","series-title":"Neurosurgery","first-page":"1398","article-title":"Analytical evaluation of complex anterior approaches to the cranial base: an anatomic study","volume":"43","author":"Ammirati","year":"1998"},{"issue":"1 Suppl Operative","key":"b2-0370007","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":"b3-0370007","series-title":"J Neurosurg","first-page":"654","article-title":"Giant anterior clinoidal meningiomas: surgical technique and outcomes. Clinical article","volume":"117","author":"Attia","year":"2012"},{"issue":"5","key":"b4-0370007","series-title":"Neurosurg Focus","first-page":"E1","article-title":"Surgical decision-making strategies in tuberculum sellae meningioma resection","volume":"30","author":"Bowers","year":"2011"},{"key":"b5-0370007","series-title":"J Neurosurg","first-page":"1","article-title":"Editorial. Craniopharyngiomas","volume":"109","author":"Cappabianca","year":"2008"},{"key":"b6-0370007","series-title":"J Neurosurg","first-page":"99","article-title":"Endoscopic endonasal transsphenoidal approach for pituitary adenomas invading the cavernous sinus","volume":"112","author":"Ceylan","year":"2010"},{"key":"b7-0370007","series-title":"Acta Neurochir (Wien)","first-page":"1","article-title":"Extended endoscopic transphenoidal approach for tuberculum sellae meningiomas","volume":"153","author":"Ceylan","year":"2011"},{"key":"b8-0370007","series-title":"Meningiomas: A Comprehensive Text","first-page":"373","article-title":"Olfactory groove meningiomas","author":"Coppens","year":"2010"},{"key":"b9-0370007","series-title":"Pituitary","first-page":"169","article-title":"Hypophysopexy technique for radiosurgical treatment of cavernous sinus pituitary adenoma","volume":"5","author":"Couldwell","year":"2002"},{"key":"b10-0370007","series-title":"Neurosurgery","first-page":"539","article-title":"Variations on the standard transsphenoidal approach to the sellar region, with emphasis on the extended approaches and parasellar approaches: surgical experience in 105 cases","volume":"55","author":"Couldwell","year":"2004"},{"issue":"6 Suppl 3","key":"b11-0370007","series-title":"Neurosurgery","first-page":"1192","article-title":"Extended endoscopic transsphenoidal approach for tuberculum sellae meningiomas","volume":"62","author":"de Divitiis","year":"2008"},{"key":"b12-0370007","series-title":"Neurosurgery","first-page":"556","article-title":"Tuberculum sellae meningiomas: high route or low route? A series of 51 consecutive cases","volume":"62","author":"de Divitiis","year":"2008"},{"key":"b13-0370007","series-title":"Neurosurgery","first-page":"677","article-title":"Expanded endoscopic endonasal approach for anterior cranial base and suprasellar lesions: indications and limitations","volume":"64","author":"Dehdashti","year":"2009"},{"key":"b14-0370007","series-title":"J Neurooncol","first-page":"239","article-title":"Surgical treatment of anterior basal meningiomas","volume":"29","author":"DeMonte","year":"1996"},{"issue":"5 Suppl 2","key":"b15-0370007","series-title":"Neurosurgery","first-page":"269","article-title":"Endonasal versus supraorbital keyhole removal of craniopharyngiomas and tuberculum sellae meningiomas","volume":"64","author":"Fatemi","year":"2009"},{"key":"b16-0370007","series-title":"Neurosurgery","first-page":"E260","article-title":"Endoscopic endonasal approach for tuberculum sellae meningiomas","volume":"69","author":"Fernandez-Miranda","year":"2011"},{"key":"b17-0370007","series-title":"Br J Neurosurg","first-page":"422","article-title":"Fronto-basal interhemispheric approach for tuberculum sellae meningiomas; long-term visual outcome","volume":"23","author":"Ganna","year":"2009"},{"key":"b18-0370007","series-title":"World Neurosurg","first-page":"563","article-title":"Gasket seal closure for extended endonasal endoscopic skull base surgery: efficacy in a large case series","volume":"80","author":"Garcia-Navarro","year":"2013"},{"key":"b19-0370007","series-title":"Neurosurgery","first-page":"36","article-title":"Endoscopic endonasal resection of anterior cranial base meningiomas","volume":"63","author":"Gardner","year":"2008"},{"key":"b20-0370007","series-title":"Neurosurgery","first-page":"883","article-title":"Endoscopic endonasal transethmoidal transcribriform transfovea ethmoidalis approach to the anterior cranial fossa and skull base","volume":"66","author":"Greenfield","year":"2010"},{"key":"b21-0370007","series-title":"Laryngoscope","first-page":"1882","article-title":"A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap","volume":"116","author":"Hadad","year":"2006"},{"issue":"6","key":"b22-0370007","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Olfactory groove meningiomas","volume":"14","author":"Hentschel","year":"2003"},{"key":"b23-0370007","series-title":"World Neurosurg","article-title":"Incidence and significance of intraoperative cerebrospinal fluid leak in endoscopic pituitary surgery using intrathecal fluorescein","author":"Jakimovski","year":"2013"},{"key":"b24-0370007","series-title":"Minim Invasive Neurosurg","first-page":"185","article-title":"Endoscopic glabellar approach to the anterior skull base: a technical note","volume":"45","author":"Jho","year":"2002"},{"key":"b25-0370007","series-title":"Neurosurgery","first-page":"94","article-title":"Transsphenoidal approaches for the extracapsular resection of midline suprasellar and anterior cranial base lesions","volume":"49","author":"Kaptain","year":"2001"},{"key":"b26-0370007","series-title":"J Neurosurg","first-page":"1544","article-title":"Endoscopic endonasal skull base surgery: analysis of complications in the authors\u2019 initial 800 patients. A review","volume":"114","author":"Kassam","year":"2011"},{"key":"b27-0370007","series-title":"Am J Surg","first-page":"591","article-title":"Complications of intracranial facial resection for tumors of the paranasal sinuses","volume":"112","author":"Ketcham","year":"1966"},{"key":"b28-0370007","series-title":"Am J Surg","first-page":"698","article-title":"A combined intracranial facial approach to the paranasal sinuses","volume":"106","author":"Ketcham","year":"1963"},{"key":"b29-0370007","series-title":"J Clin Neurosci","first-page":"927","article-title":"Pure endoscopic expanded endonasal approach for olfactory groove and tuberculum sellae meningiomas","volume":"21","author":"Khan","year":"2014"},{"key":"b30-0370007","series-title":"J Neurosurg","first-page":"999","article-title":"Extended transsphenoidal approach with submucosal posterior ethmoidectomy for parasellar tumors. Technical note","volume":"94","author":"Kitano","year":"2001"},{"key":"b31-0370007","series-title":"J Neurosurg","first-page":"337","article-title":"Postoperative improvement in visual function in patients with tuberculum sellae meningiomas: results of the extended transsphenoidal and transcranial approaches","volume":"107","author":"Kitano","year":"2007"},{"issue":"6","key":"b32-0370007","series-title":"Neurosurg Focus","first-page":"E6","article-title":"Endoscopic extended transsphenoidal resection of tuberculum sellae meningiomas: nuances of neurosurgical technique","volume":"35","author":"Kulwin","year":"2013"},{"key":"b33-0370007","series-title":"J Neurosurg","first-page":"400","article-title":"Endoscopic, endonasal extended transsphenoidal, transplanum transtuberculum approach for resection of suprasellar lesions","volume":"106","author":"Laufer","year":"2007"},{"issue":"1 Suppl 1","key":"b34-0370007","series-title":"Neurosurgery","first-page":"ONS108","article-title":"A surgical technique for the removal of clinoidal meningiomas","volume":"59","author":"Lee","year":"2006"},{"issue":"5 Suppl 2","key":"b35-0370007","series-title":"Neurosurgery","first-page":"ONSE342","article-title":"\u201cGasket-seal\u201d watertight closure in minimal-access endoscopic cranial base surgery","volume":"62","author":"Leng","year":"2008"},{"issue":"5","key":"b36-0370007","series-title":"Neurosurg Focus","first-page":"E11","article-title":"Hypophysial transposition (hypophysopexy) for radiosurgical treatment of pituitary tumors involving the cavernous sinus. 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