{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:22:08Z","timestamp":1792092128918,"version":"4.4.0"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Planum sphenoidale (PS) and tuberculum sellae (TS) meningiomas cause visual symptoms due to compression of the optic chiasm. The treatment of choice is surgical removal with the goal of improving vision and achieving complete tumor removal. Two options exist to remove these tumors: the transcranial approach (TCA) and the endonasal endoscopic approach (EEA). Significant controversy exists regarding which approach provides the best results and whether there is a subset of patients for whom an EEA may be more suitable. Comparisons using a similar cohort of patients, namely, those suitable for gross-total resection with EEA, are lacking from the literature.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The authors reviewed all cases of PS and TS meningiomas that were surgically removed at Weill Cornell Medical College between 2000 and 2015 (TCA) and 2008 and 2015 (EEA). All cases were shown to a panel of 3 neurosurgeons to find only those tumors that could be removed equally well either through an EEA or TCA to standardize both groups. Volumetric measurements of preoperative and postoperative tumor size, FLAIR images, and apparent diffusion coefficient maps were assessed by 2 independent reviewers and compared to assess extent of resection and trauma to the surrounding brain. Visual outcome and complications were also compared.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n Thirty-two patients were identified who underwent either EEA (n = 17) or TCA (n = 15). The preoperative tumor size was comparable (mean 5.58 \u00b1 3.42 vs 5.04 \u00b1 3.38 cm\n 3<\/jats:sup>\n [\u00b1 SD], p = 0.661). The average extent of resection achieved was not significantly different between the 2 groups (98.80% \u00b1 3.32% vs 95.13% \u00b1 11.69%, p = 0.206). Postoperatively, the TCA group demonstrated a significant increase in the FLAIR\/edema signal compared with EEA patients (4.15 \u00b1 7.10 vs \u22120.69 \u00b1 2.73 cm\n 3<\/jats:sup>\n , p = 0.014). In addition, the postoperative diffusion-weighted imaging signal of cytotoxic ischemic damage was significantly higher in the TCA group than in the EEA group (1.88 \u00b1 1.96 vs 0.40 \u00b1 0.55 cm\n 3<\/jats:sup>\n , p =0.008). Overall, significantly more EEA patients experienced improved or stable visual outcomes compared with TCA patients (93% vs 56%, p = 0.049). Visual deterioration was greater after TCA than EEA (44% vs 0%, p = 0.012). While more patients experienced postoperative seizures after TCA than after EEA (27% vs 0%, p = 0.038), there was a trend toward more CSF leakage and anosmia after EEA than after TCA (11.8% vs 0%, p = 0.486 and 11.8% vs 0%, p = 0.118, respectively).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n In this small single-institution study of similarly sized and located PS and TS meningiomas, EEA provided equivalent rates of resection with better visual results, less trauma to the brain, and fewer seizures. These preliminary results merit further investigation in a larger multiinstitutional study and may support EEA resection by experienced surgeons in a subset of carefully selected PS and TS meningiomas.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2016.9.jns16823","type":"journal-article","created":{"date-parts":[[2017,1,27]],"date-time":"2017-01-27T09:59:34Z","timestamp":1485511174000},"page":"40-48","source":"Crossref","is-referenced-by-count":122,"title":["Endoscopic endonasal versus transcranial approach to tuberculum sellae and planum sphenoidale meningiomas in a similar cohort of patients"],"prefix":"10.3171","volume":"128","author":[{"given":"Evan D.","family":"Bander","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harminder","family":"Singh","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neurosurgery, Stanford University School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin B.","family":"Ogilvie","sequence":"additional","affiliation":[{"name":"Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan C.","family":"Cusic","sequence":"additional","affiliation":[{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Pisapia","sequence":"additional","affiliation":[{"name":"Pathology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apostolos John","family":"Tsiouris","sequence":"additional","affiliation":[{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay K.","family":"Anand","sequence":"additional","affiliation":[{"name":"Otolaryngology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore H.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Otolaryngology,"},{"name":"Neuroscience,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1 Suppl Operative","key":"b1-jns16823","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 M,","year":"2012","unstructured":"Attia M, Kandasamy J, Jakimovski D, Bedrosian J, Alimi M, Lee DLY, : The importance and timing of optic canal exploration and decompression during endoscopic endonasal resection of tuberculum sella and planum sphenoidale meningiomas. 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