{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:51:48Z","timestamp":1791276708735,"version":"4.1.0"},"reference-count":92,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Endoscopic endonasal surgery (EES) has fundamentally changed the management of anterior skull base meningiomas by enabling access to many lesions through a direct minimally invasive corridor that avoids traditional transcranial exposure. Improvements in endoscopic optical technology, surgical instrumentation, and skull base reconstruction have steadily expanded the range of tumors that can be treated through an endonasal approach. Even so, EES is not appropriate for every lesion, making thoughtful patient selection and surgical team experience the most important determinants of surgical success. This review explores where EES fits in the contemporary management of anterior skull base meningiomas, including olfactory groove, tuberculum sellae, and planum sphenoidale meningiomas, with particular attention to its indications, limitations, and situations in which EES may not be appropriate. Evidence comparing endoscopic endonasal and transcranial approaches for anterior skull base meningiomas is reviewed, with attention to how tumor anatomy, oncologic objectives, and individual patient characteristics influence the choice of approach. A major consideration is how surgical morbidity can be minimized without compromising oncologic and safety outcomes. Current strategies to protect critical neurovascular structures, reduce the risk of cerebrospinal fluid leakage, and improve skull base durability, including advances in vascularized reconstruction techniques, are discussed. Emerging outcome data and the evolving learning curve associated with EES are also reviewed. Rather than presenting EES as a universal solution, the evidence points toward a patient-centered approach in which operative strategy and clinical decision making is guided by tumor characteristics, anatomy, and surgical goals.<\/jats:p>","DOI":"10.3390\/cancers18193217","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:06:47Z","timestamp":1791274007000},"page":"3217","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic Endonasal Approaches to Anterior Cranial Base Meningiomas: Indications, Limitations, and Surgical Decision-Making"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8212-0814","authenticated-orcid":false,"given":"Manat","family":"Chopra","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"John","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Cote","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Zada","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.rpor.2015.12.008","article-title":"Imaging of skull base tumours","volume":"21","author":"Thust","year":"2016","journal-title":"Rep. Pract. Oncol. Radiother."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1586\/14737175.2014.892830","article-title":"Tumors of the anterior skull base","volume":"14","author":"Ivan","year":"2014","journal-title":"Expert Rev. Neurother."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Plou, P., Serioli, S., Leonel, L.C.P.C., Alexander, A.Y., Agosti, E., Vilany, L., Graepel, S., Choby, G., Pinheiro-Neto, C.D., and Peris-Celda, M. (2023). Surgical Anatomy and Approaches of the Anterior Cranial Fossa from a Transcranial and Endonasal Perspective. Cancers, 15.","DOI":"10.3390\/cancers15092587"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.rpor.2014.09.002","article-title":"Surgical management of skull base tumors","volume":"21","author":"Russin","year":"2016","journal-title":"Rep. Pract. Oncol. Radiother."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Ungureanu, G., Serban, L.-N., and Florian, S.-I. (2025). Optimizing Surgical Management of Anterior Skull Base Meningiomas: Imaging Modalities, Key Surgical Considerations, and Risk Mitigation Strategies. Cancers, 17.","DOI":"10.3390\/cancers17060987"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"035","DOI":"10.1055\/s-2001-12786","article-title":"Trans-Sinusal Frontal Approach for Olfactory Groove Meningiomas","volume":"11","author":"Hallacq","year":"2001","journal-title":"Skull Base"},{"key":"ref_7","first-page":"E2","article-title":"Endoscopic endonasal surgery of the midline skull base: Anatomical study and clinical considerations","volume":"19","author":"Cavallo","year":"2005","journal-title":"Neurosurg. Focus"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"44","DOI":"10.3171\/jns.1997.87.1.0044","article-title":"Endoscopic endonasal transsphenoidal surgery: Experience with 50 patients","volume":"87","author":"Jho","year":"1997","journal-title":"J. Neurosurg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.wneu.2011.08.025","article-title":"Endoscopic Endonasal versus Open Transcranial Resection of Anterior Midline Skull Base Meningiomas","volume":"77","author":"Komotar","year":"2012","journal-title":"World Neurosurg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1882","DOI":"10.1097\/01.mlg.0000234933.37779.e4","article-title":"A Novel Reconstructive Technique After Endoscopic Expanded Endonasal Approaches: Vascular Pedicle Nasoseptal Flap","volume":"116","author":"Hadad","year":"2006","journal-title":"Laryngoscope"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1227\/01.NEU.0000316852.01820.45","article-title":"Endoscopic Endonasal Resection of Anterior Cranial Base Meningiomas","volume":"63","author":"Gardner","year":"2008","journal-title":"Neurosurgery"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/j.wneu.2015.05.019","article-title":"The Expanding Spectrum of Disease Treated by the Transnasal, Transsphenoidal Microscopic and Endoscopic Anterior Skull Base Approach: A Single-Center Experience 2008\u20132015","volume":"84","author":"Cote","year":"2015","journal-title":"World Neurosurg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"735","DOI":"10.2176\/nmc.ra.2015-0031","article-title":"Current Status of Endoscopic Endonasal Surgery for Skull Base Meningiomas: Review of the Literature","volume":"55","author":"Shin","year":"2015","journal-title":"Neurol. Med. Chir."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s00701-017-3390-y","article-title":"The endoscopic endonasal approach is not superior to the microscopic transcranial approach for anterior skull base meningiomas\u2014A meta-analysis","volume":"160","author":"Muskens","year":"2018","journal-title":"Acta Neurochir."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Aftahy, A.K., Barz, M., Krauss, P., Wagner, A., Lange, N., Hijazi, A., Wiestler, B., Meyer, B., Negwer, C., and Gempt, J. (2020). Midline Meningiomas of the Anterior Skull Base: Surgical Outcomes and a Decision-Making Algorithm for Classic Skull Base Approaches. Cancers, 12.","DOI":"10.3390\/cancers12113243"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"E7","DOI":"10.3171\/2018.1.FOCUS17734","article-title":"Decision-making algorithm for minimally invasive approaches to anterior skull base meningiomas","volume":"44","author":"Ottenhausen","year":"2018","journal-title":"Neurosurg. Focus"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.1097\/SCS.0000000000005562","article-title":"Expanded Endoscopic Approach for Anterior Skull Base Tumors: Experience of a Multidisciplinary Skull Base Team","volume":"30","author":"Marchioni","year":"2019","journal-title":"J. Craniofacial Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1227\/01.NEU.0000325725.77132.90","article-title":"Pituitary hormonal loss and recovery after transsphenoidal adenoma removal","volume":"63","author":"Fatemi","year":"2008","journal-title":"Neurosurgery"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.otc.2017.01.003","article-title":"Evolution in Visualization for Sinus and Skull Base Surgery","volume":"50","author":"Ahmed","year":"2017","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1055\/s-0032-1301391","article-title":"Expanded endoscopic endonasal approaches to skull base meningiomas","volume":"73","author":"Prosser","year":"2012","journal-title":"J. Neurol. Surg. B Skull Base"},{"key":"ref_21","first-page":"i29","article-title":"Beyond the sella: Expanded endoscopic endonasal approaches for pituitary tumors","volume":"7","author":"Alli","year":"2025","journal-title":"Neurooncol. Adv."},{"key":"ref_22","first-page":"E3","article-title":"Expanded endonasal approach: The rostrocaudal axis. Part I. Crista galli to the sella turcica","volume":"19","author":"Kassam","year":"2005","journal-title":"Neurosurg. Focus"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1002\/lio2.471","article-title":"Vascular pedicled flaps for skull base defect reconstruction","volume":"5","author":"Gutierrez","year":"2020","journal-title":"Laryngoscope Investig. Otolaryngol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"S300","DOI":"10.1055\/s-0038-1669463","article-title":"The Endoscopic Endonasal Management of Anterior Skull Base Meningiomas","volume":"79","author":"Zoli","year":"2018","journal-title":"J. Neurol. Surg. B Skull Base"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"12782","DOI":"10.1038\/s41598-026-43689-0","article-title":"Skull base reconstruction strategy for high-flow CSF leaks during EEA surgery based on the quality of pedicled nasoseptal flap","volume":"16","author":"Fu","year":"2026","journal-title":"Sci. Rep."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Ahmed, A.K., Rowan, N.R., and Mukherjee, D. (2024). Operative Corridors in Endoscopic Skull Base Tumor Surgery. Brain Sci., 14.","DOI":"10.3390\/brainsci14030207"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"118","DOI":"10.23736\/S0390-5616.20.05085-7","article-title":"Endoscopic endonasal surgery for anterior cranial fossa meningiomas","volume":"65","author":"Algattas","year":"2021","journal-title":"J. Neurosurg. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Agosti, E., Alexander, A.Y., Antonietti, S., Zeppieri, M., Piazza, A., Panciani, P.P., Fontanella, M.M., Pinheiro-Neto, C., Ius, T., and Peris-Celda, M. (2024). Comparative Efficacy of Transsphenoidal and Transcranial Approaches for Treating Tuberculum Sellae Meningiomas: A Systematic Review and Meta-Analysis. J. Clin. Med., 13.","DOI":"10.3390\/jcm13082356"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1227\/01.neu.0000303221.63016.f2","article-title":"Extended Endoscopic Transsphenoidal Approach for Tuberculum Sellae Meningiomas","volume":"61","author":"Cavallo","year":"2007","journal-title":"Oper. Neurosurg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1007\/s00701-020-04641-x","article-title":"Trends in cerebrospinal fluid leak rates following the extended endoscopic endonasal approach for anterior skull base meningioma: A meta-analysis over the last 20 years","volume":"163","author":"Khan","year":"2021","journal-title":"Acta Neurochir."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"211","DOI":"10.2217\/cns-2016-0007","article-title":"Endoscopic transnasal surgery for planum and tuberculum sella meningiomas: Decision-making, technique and outcomes","volume":"5","author":"Kshettry","year":"2016","journal-title":"CNS Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.3171\/2014.2.JNS13767","article-title":"Endoscopic endonasal surgery for suprasellar meningiomas: Experience with 75 patients: Clinical article","volume":"120","author":"Koutourousiou","year":"2014","journal-title":"J. Neurosurg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1055\/s-2008-1052019","article-title":"Endoscopic Endonasal Transsphenoidal Approach to the Sella: Towards Functional Endoscopic Pituitary Surgery (FEPS)*","volume":"41","author":"Cappabianca","year":"1998","journal-title":"Minim. Invasive Neurosurg."},{"key":"ref_34","first-page":"E8","article-title":"Endoscopic endonasal surgery for olfactory groove meningiomas: Outcomes and limitations in 50 patients","volume":"37","author":"Koutourousiou","year":"2014","journal-title":"J. Neurosurg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.jocn.2024.03.001","article-title":"Endoscopic endonasal approach for olfactory groove meningioma resection: Strategies and outcomes in a retrospective case series","volume":"122","author":"Wang","year":"2024","journal-title":"J. Clin. Neurosci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.otot.2006.06.002","article-title":"Endonasal micro-endoscopic treatment of malignant tumors of the paranasal sinuses and anterior skull base","volume":"17","author":"Castelnuovo","year":"2006","journal-title":"Oper. Tech. Otolaryngol.-Head Neck Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1007\/s11912-011-0151-6","article-title":"Endoscopic Resection of Sinonasal Malignancies","volume":"13","author":"Nicolai","year":"2011","journal-title":"Curr. Oncol. Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"308","DOI":"10.2500\/ajr.2008.22.3170","article-title":"Endoscopic Surgery for Malignant Tumors of the Sinonasal Tract and Adjacent Skull Base: A 10-year Experience","volume":"22","author":"Nicolai","year":"2008","journal-title":"Am. J. Rhinol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1007\/s00701-014-2174-x","article-title":"Primary dural closure and anterior cranial base reconstruction using pericranial and nasoseptal multi-layered flaps in endoscopic-assisted skull base surgery","volume":"156","author":"Tomio","year":"2014","journal-title":"Acta Neurochir."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.3171\/2013.8.FOCUS13274","article-title":"A proposed grading system for standardizing tumor consistency of intracranial meningiomas","volume":"35","author":"Zada","year":"2013","journal-title":"Neurosurg. Focus"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"119","DOI":"10.4103\/ajns.AJNS_179_20","article-title":"Lifesaving decompressive craniectomy for high intracranial pressure attributed to deep-seated meningioma: Emergency management","volume":"16","author":"Haq","year":"2021","journal-title":"Asian J. Neurosurg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1544","DOI":"10.3171\/2010.10.JNS09406","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","journal-title":"J. Neurosurg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1002\/jso.21020","article-title":"Endoscopic skull base surgery: Principles of endonasal oncological surgery","volume":"97","author":"Snyderman","year":"2008","journal-title":"J. Surg. Oncol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1159\/000329250","article-title":"The Learning Curve for Endonasal Surgery of the Cranial Base: A Systematic Approach to Training","volume":"Volume 26","author":"Kassam","year":"2012","journal-title":"Progress in Neurological Surgery"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1055\/s-0029-1238214","article-title":"Light at the end of the tunnel: The learning curve associated with endoscopic transsphenoidal skull base surgery","volume":"20","author":"Smith","year":"2010","journal-title":"Skull Base"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.wneu.2014.11.001","article-title":"Olfactory Groove Meningioma: Report of 99 Cases Surgically Treated at the Catholic University School of Medicine, Rome","volume":"83","author":"Pallini","year":"2015","journal-title":"World Neurosurg."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1227\/01.NEU.0000255453.20602.80","article-title":"Olfactory Groove Meningiomas: Clinical Outcome and Recurrence Rates After Tumor Removal Through the Frontolateral and Bifrontal Approach","volume":"60","author":"Nakamura","year":"2007","journal-title":"Neurosurgery"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/S0967-5868(99)90051-6","article-title":"Giant olfactory groove meningiomas: Advantages of the bilateral fronto-orbitonasal approach","volume":"6","author":"Tamaki","year":"1999","journal-title":"J. Clin. Neurosci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.nec.2015.03.009","article-title":"Endoscopic Endonasal Approach for Olfactory Groove Meningiomas","volume":"26","author":"Liu","year":"2015","journal-title":"Neurosurg. Clin. N. Am."},{"key":"ref_50","first-page":"E3","article-title":"Surgical nuances for removal of olfactory groove meningiomas using the endoscopic endonasal transcribriform approach","volume":"30","author":"Liu","year":"2011","journal-title":"J. Neurosurg."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.clineuro.2018.08.029","article-title":"Olfactory groove and tuberculum sellae meningioma resection by endoscopic endonasal approach versus transcranial approach: A systematic review and meta-analysis of comparative studies","volume":"174","author":"Lu","year":"2018","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_52","first-page":"208","article-title":"Surgical Approaches to Resection of Olfactory Groove Meningiomas: Comparative Meta-analysis of the Endoscopic Endonasal versus Transcranial and Unilateral versus Bilateral Approaches","volume":"86","author":"Brown","year":"2024","journal-title":"J. Neurol. Surgery. Part B Skull Base"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1017\/cjn.2024.298","article-title":"Outcomes of Endoscopic Endonasal Surgery for Tuberculum Sellae and Planum Sphenoidale Meningiomas: A Retrospective Study","volume":"52","author":"Schroeder","year":"2024","journal-title":"Can. J. Neurol. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e273","DOI":"10.1227\/ons.0000000000000746","article-title":"Endoscopic Endonasal Approach for Tuberculum Sellae Meningioma: 2-Dimensional Operative Video","volume":"25","author":"Cavallo","year":"2023","journal-title":"Oper. Neurosurg."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.wneu.2014.03.032","article-title":"Endoscopic Endonasal Resection of Suprasellar Meningiomas: The Importance of Case Selection and Experience in Determining Extent of Resection, Visual Improvement, and Complications","volume":"82","author":"Ottenhausen","year":"2014","journal-title":"World Neurosurg."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"10560","DOI":"10.1097\/JS9.0000000000004737","article-title":"Visual outcomes following endoscopic endonasal approach for tuberculum sellae meningiomas a systematic review and meta-analysis","volume":"112","author":"Lee","year":"2026","journal-title":"Int. J. Surg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1007\/s00701-019-04114-w","article-title":"Surgical management of Tuberculum sellae Meningiomas: Myths, facts, and controversies","volume":"162","author":"Giammattei","year":"2020","journal-title":"Acta Neurochir."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1016\/j.jocn.2006.09.003","article-title":"Surgical management of Tuberculum sellae meningiomas","volume":"14","author":"Li","year":"2007","journal-title":"J. Clin. Neurosci."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1227\/neu.0000000000002569","article-title":"International Tuberculum Sellae Meningioma Study: Surgical Outcomes and Management Trends","volume":"93","author":"Magill","year":"2023","journal-title":"Neurosurgery"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"113","DOI":"10.3171\/2020.4.JNS20475","article-title":"Endoscopic endonasal approach for suprasellar meningiomas: Introduction of a new scoring system to predict extent of resection and assist in case selection with long-term outcome data","volume":"135","author":"Youngerman","year":"2020","journal-title":"J. Neurosurg."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"148","DOI":"10.3171\/jns.2006.105.1.148","article-title":"Decompression of cavernous sinus meningioma for preservation and improvement of cranial nerve function: Technical note","volume":"105","author":"Couldwell","year":"2006","journal-title":"J. Neurosurg."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"848","DOI":"10.3171\/2017.9.JNS171406","article-title":"Defining the lateral limits of the endoscopic endonasal transtuberculum transplanum approach: Anatomical study with pertinent quantitative analysis","volume":"130","author":"Torales","year":"2019","journal-title":"J. Neurosurg."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"125015","DOI":"10.1016\/j.wneu.2026.125015","article-title":"Comparative Efficacy of Endoscopic Endonasal versus Transcranial Approaches for Treating Olfactory Groove Meningiomas: A Systematic Review and Meta-Analysis","volume":"211","author":"Hafiz","year":"2026","journal-title":"World Neurosurg."},{"key":"ref_64","doi-asserted-by":"crossref","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","journal-title":"Adv. Tech. Stand. Neurosurg."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1227\/01.NEU.0000255354.64077.66","article-title":"Graded Repair of Cranial Base Defects and Cerebrospinal Fluid Leaks in Transsphenoidal Surgery","volume":"60","author":"Esposito","year":"2007","journal-title":"Oper. Neurosurg."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1055\/s-0030-1253573","article-title":"How to choose? Endoscopic skull base reconstructive options and limitations","volume":"20","author":"Patel","year":"2010","journal-title":"Skull Base"},{"key":"ref_67","first-page":"296","article-title":"Olfactory Outcomes after Resection of Tuberculum Sella and Planum Sphenoidale Meningiomas via a Transcranial Approach","volume":"83","author":"Ved","year":"2021","journal-title":"J. Neurol. Surg. B Skull Base"},{"key":"ref_68","first-page":"57","article-title":"Dural Closure Method Using Dural Suture and Polyglycolic Acid Nonwoven Fabric in the Endoscopic Endonasal Approach","volume":"87","author":"Tanioka","year":"2024","journal-title":"J. Neurol. Surg. B Skull Base"},{"key":"ref_69","first-page":"157","article-title":"Are Routine Lumbar Drains Necessary for Endoscopic Reconstruction after Resection of Anterior and Central Skull Base Tumors?","volume":"87","author":"Harris","year":"2025","journal-title":"J. Neurol. Surg. B Skull Base"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.3171\/2018.4.JNS172447","article-title":"Does lumbar drainage reduce postoperative cerebrospinal fluid leak after endoscopic endonasal skull base surgery? A prospective, randomized controlled trial","volume":"131","author":"Zwagerman","year":"2018","journal-title":"J. Neurosurg."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1227\/ons.0000000000001656","article-title":"Safety Profile of Select Perioperative Lumbar Drain Use After Endoscopic Endonasal Surgery","volume":"30","author":"Wishart","year":"2026","journal-title":"Oper. Neurosurg."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1055\/s-0035-1568871","article-title":"Endoscopic Endonasal Reconstruction of Skull Base: Repair Protocol","volume":"77","author":"Dehdashti","year":"2015","journal-title":"J. Neurol. Surg. B Skull Base"},{"key":"ref_73","first-page":"853","article-title":"A Comparative Study of Endoscopic Skull Base Repair Using Pedicled Flap, Fascia Lata Graft, and Fat Graft","volume":"7","author":"Chandran","year":"2026","journal-title":"Int. J. Med. Pharm. Res."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"e306","DOI":"10.1055\/s-0040-1701211","article-title":"Evaluating an Image-Guided Operating Room with Cone Beam CT for Skull Base Surgery","volume":"82","author":"Muhanna","year":"2021","journal-title":"J. Neurol. Surg. B Skull Base"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Yamano, A., Matsuda, M., and Ishikawa, E. (2024). Preoperative Vascular and Cranial Nerve Imaging in Skull Base Tumors. Cancers, 17.","DOI":"10.3390\/cancers17010062"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1227\/01.NEU.0000255408.84269.A8","article-title":"Avoidance of Carotid Artery Injuries in Transsphenoidal Surgery with the Doppler Probe and Micro-Hook Blades","volume":"60","author":"Dusick","year":"2007","journal-title":"Oper. Neurosurg."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.wneu.2016.06.008","article-title":"Multimodal Navigation in Endoscopic Transsphenoidal Resection of Pituitary Tumors Using Image-Based Vascular and Cranial Nerve Segmentation: A Prospective Validation Study","volume":"95","author":"Dolati","year":"2016","journal-title":"World Neurosurg."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1007\/s11102-010-0280-1","article-title":"Endoscopic endonasal approach for pituitary adenoma: Surgical complications in 301 patients","volume":"14","author":"Gondim","year":"2011","journal-title":"Pituitary"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"e291","DOI":"10.1055\/s-0041-1726128","article-title":"Clinical Efficacy of the Multilayered Skull Base Reconstruction Using In Situ Bone Flap in Endoscopic Endonasal Approach for Craniopharyngioma","volume":"83","author":"Zhou","year":"2021","journal-title":"J. Neurol. Surg. B Skull Base"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1177\/1553350619861563","article-title":"The Effect of Training, Used-Hand, and Experience on Endoscopic Surgery Skills in an Educational Computer-Based Simulation Environment (ECE) for Endoneurosurgery Training","volume":"26","author":"Cagiltay","year":"2019","journal-title":"Surg. Innov."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1002\/lary.24385","article-title":"Augmented real-time navigation with critical structure proximity alerts for endoscopic skull base surgery","volume":"124","author":"Dixon","year":"2014","journal-title":"Laryngoscope"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1002\/alr.20007","article-title":"Real-time tracking and virtual endoscopy in cone-beam CT-guided surgery of the sinuses and skull base in a cadaver model","volume":"1","author":"Prisman","year":"2011","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"e1886","DOI":"10.1002\/rcs.1886","article-title":"Endoscopic navigation system with extended field of view using augmented reality technology","volume":"14","author":"Bong","year":"2018","journal-title":"Robot. Comput. Surg."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"90","DOI":"10.4274\/balkanmedj.galenos.2025.2025.180225","article-title":"Advances and the Future of Skull Base Surgery","volume":"42","author":"Vural","year":"2025","journal-title":"Balk. Med. J."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Lai, M., Skyrman, S., Shan, C., Babic, D., Homan, R., Edstr\u00f6m, E., Persson, O., Burstr\u00f6m, G., Elmi-Terander, A., and Hendriks, B.H.W. (2020). Fusion of augmented reality imaging with the endoscopic view for endonasal skull base surgery; a novel application for surgical navigation based on intraoperative cone beam computed tomography and optical tracking. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0229454"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"248","DOI":"10.3171\/2017.9.JNS171253","article-title":"3D printing and intraoperative neuronavigation tailoring for skull base reconstruction after extended endoscopic endonasal surgery: Proof of concept","volume":"130","author":"Essayed","year":"2019","journal-title":"J. Neurosurg."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"5333","DOI":"10.1038\/s41598-021-84779-5","article-title":"Application of 3D printed model for planning the endoscopic endonasal transsphenoidal surgery","volume":"11","author":"Huang","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1055\/s-0037-1607274","article-title":"Endoscopic Endonasal Reconstructive Methods to the Anterior Skull Base","volume":"31","author":"Chakravarthi","year":"2017","journal-title":"Semin Plast. Surg."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Porras, J.L., Rowan, N.R., and Mukherjee, D. (2022). Endoscopic Endonasal Skull Base Surgery Complication Avoidance: A Contemporary Review. Brain Sci., 12.","DOI":"10.3390\/brainsci12121685"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1093\/ons\/opab187","article-title":"Machine Vision for Real-Time Intraoperative Anatomic Guidance: A Proof-of-Concept Study in Endoscopic Pituitary Surgery","volume":"21","author":"Staartjes","year":"2021","journal-title":"Oper. Surg."},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Rech, M.M., de Macedo Filho, L., White, A.J., Perez-Vega, C., Samson, S.L., Chaichana, K.L., Olomu, O.U., Quinones-Hinojosa, A., and Almeida, J.P. (2023). Machine Learning Models to Forecast Outcomes of Pituitary Surgery: A Systematic Review in Quality of Reporting and Current Evidence. Brain Sci., 13.","DOI":"10.3390\/brainsci13030495"},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Tanioka, D., Natori, I., and Morofuji, Y. (2026). Frontiers of Innovation and Clinical Application in Endoscopic Endonasal Transsphenoidal Surgery. J. Clin. Med., 15.","DOI":"10.3390\/jcm15041504"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/19\/3217\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:09:27Z","timestamp":1791274167000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/19\/3217"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":92,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["cancers18193217"],"URL":"https:\/\/doi.org\/10.3390\/cancers18193217","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]}}}