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Early optic nerve decompression, whether performed via endoscopic endonasal or transcranial routes, is a critical determinant of postoperative visual preservation in tuberculum sellae meningioma surgery. Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

August 22, 2026Neurology India

Two Routes, One Goal: Early Optic Nerve Decompression from Above and Below in Minimal Access Tuberculum Sellae Meningioma Surgery

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Authors

ACAshutosh Carpenter JGJaskaran Singh Gosal MSMohammedali Shefna

Discussion

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Overview

Surgical technique report demonstrates early optic nerve decompression in tuberculum sellae meningiomas, indicating approach selection depends on tumor location and vascular anatomy.

Key Points

To demonstrate the surgical techniques and anatomical considerations for early optic nerve decompression in tuberculum sellae meningioma surgery using both endoscopic endonasal and transcranial approaches.
Demonstration of the extended endoscopic endonasal approach (EEEA) achieving 270° optic canal unroofing and inferomedial optic sheath fenestration.
Demonstration of the transcranial corridor utilizing extradural-intradural falciform ligament division, medial optic canal drilling, and superior-lateral optic sheath decompression.
Extended endoscopic endonasal surgery provides direct access to inferomedial optic canal invasion and the preforaminal-canalicular corridor.
The transcranial corridor remains necessary for tumors presenting with supradiaphragmatic extension, a prefixed chiasm, or complex vascular encasement of the A1, anterior communicating, or internal carotid arteries.
Early decompression via either corridor prevents manipulation-induced ischemia, serving as a primary determinant of postoperative visual preservation.

Cite This Study

Carpenter et al. (2026) studied this question.

synapsesocial.com/papers/6a895eeeca7ade938187d2fd https://doi.org/10.4103/neurol-india.neurol-india-d-25-00977

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August 22, 2026Neurology India

Two Routes, One Goal: Early Optic Nerve Decompression from Above and Below in Minimal Access Tuberculum Sellae Meningioma Surgery

View Full Paper

Ask AI

Bookmark

Authors

ACAshutosh Carpenter JGJaskaran Singh Gosal MSMohammedali Shefna

Discussion

Member takes

Overview

Surgical technique report demonstrates early optic nerve decompression in tuberculum sellae meningiomas, indicating approach selection depends on tumor location and vascular anatomy.

Key Points

To demonstrate the surgical techniques and anatomical considerations for early optic nerve decompression in tuberculum sellae meningioma surgery using both endoscopic endonasal and transcranial approaches.
Demonstration of the extended endoscopic endonasal approach (EEEA) achieving 270° optic canal unroofing and inferomedial optic sheath fenestration.
Demonstration of the transcranial corridor utilizing extradural-intradural falciform ligament division, medial optic canal drilling, and superior-lateral optic sheath decompression.
Extended endoscopic endonasal surgery provides direct access to inferomedial optic canal invasion and the preforaminal-canalicular corridor.
The transcranial corridor remains necessary for tumors presenting with supradiaphragmatic extension, a prefixed chiasm, or complex vascular encasement of the A1, anterior communicating, or internal carotid arteries.
Early decompression via either corridor prevents manipulation-induced ischemia, serving as a primary determinant of postoperative visual preservation.

Cite This Study

Carpenter et al. (2026) studied this question.

synapsesocial.com/papers/6a895eeeca7ade938187d2fd https://doi.org/10.4103/neurol-india.neurol-india-d-25-00977

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