Retractorless Surgery for Tuberculum Sellae Meningiomas via the Frontolateral Approach: A Single Institution's Experience.

OBJECTIVE:Although technologic advances have improved the surgical outcomes of tuberculum sellae meningiomas (TSMs), the treatment of these tumors remains challenging given important neurovascular structures involvement. In this article, the authors retrospectively reviewed the effectiveness of retractorless surgery for TSMs via the frontolateral approach (FLA). METHODS:Between 2015 and 2022, 36 patients with TSMs underwent retractorless surgery via the FLA. The gross total resection (GTR) rates, visual outcomes, and complications were evaluated as the main outcome parameters. RESULTS:GTR was achieved in 34 patients (94.4%). Visual acuity improved in 93.9% (n = 31) of the 33 patients with visual deficits and remained unchanged in 6.1% (n = 2). No patients suffered from visual deterioration, brain retraction injury, mortality, and tumor recurrence in the mean follow-up duration of 33 months. CONCLUSIONS:Retractorless surgery via the FLA is a reliable transcranial option for the treatment of TSMs. High rates of GTR, excellent visual outcomes, and the low incidence of complications could be achieved if the surgical strategy mentioned in the article is adopted.