A literature review of anatomical considerations and surgical approaches for planum sphenoidale and tuberculum sellae meningiomas.
- 1Department of Neurosurgery, Pontificia Universidad Javeriana, Bogotá, Colombia.
- 2Neurosurgery Research Group, Pontificia Universidad Javeriana, Bogotá, Colombia.
- 3Department of Neurosurgery, Hospital Universitario San Ignacio, Bogotá, Colombia.
Abstract
Background
Planum sphenoidale meningiomas (PSMs) and tuberculum sellae meningiomas (TSMs) represent a surgically challenging subset of anterior skull base tumors because of their close relationship with the optic apparatus, internal carotid arteries, anterior cerebral arteries, pituitary stalk, and hypothalamus. Although traditional anatomical distinctions have guided the choice between endoscopic endonasal and transcranial approaches (TCAs), increasing evidence suggests that individualized tumor-specific factors should drive surgical decision-making.Methods
A narrative review of the literature was performed to evaluate anatomical considerations, classification systems, surgical approaches, outcomes, and complications associated with PSMs and TSMs. Evidence regarding transcranial, endoscopic endonasal, and minimally invasive approaches was synthesized to develop a practical decision-making framework.Results
Contemporary literature shows that both transcranial and endoscopic endonasal approaches (EEAs) can achieve favorable outcomes when appropriately selected. TCAs remain advantageous for tumors with marked lateral extension, vascular encasement, or complex neurovascular relationships. EEAs may offer improved visualization of midline lesions, early devascularization, optic canal (OC) decompression, and favorable visual outcomes, although they are associated with a higher risk of cerebrospinal fluid leakage. Surgical experience, reconstruction techniques, tumor size, OC invasion, vascular involvement, and lateral extension are key determinants of outcome.Conclusion
Management of PSMs and TSMs should be individualized rather than based solely on rigid anatomical classifications. The proposed algorithm integrates anatomical, radiological, and surgical factors to support approach selection and optimize patient outcomes.
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BibTeX
@article{agudeloarrieta2026literature,
title = {{A literature review of anatomical considerations and surgical approaches for planum sphenoidale and tuberculum sellae meningiomas.}},
author = {Mariana Agudelo-Arrieta and Sergio Esteban Chacón-Valencia and Maria Isabel Ocampo-Navia and Julian Alfonso Sierra Peña and Alex Taub-Krivoy and Alejandro Vargas-Moreno and Maria Fernanda Rodríguez-Romero and Oscar Hernando Feo-Lee},
journal = {Surgical neurology international},
year = {2026},
month = oct,
doi = {10.25259/sni_658_2026},
url = {https://europepmc.org/article/MED/42974261},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - A literature review of anatomical considerations and surgical approaches for planum sphenoidale and tuberculum sellae meningiomas.
AU - Mariana Agudelo-Arrieta
AU - Sergio Esteban Chacón-Valencia
AU - Maria Isabel Ocampo-Navia
AU - Julian Alfonso Sierra Peña
AU - Alex Taub-Krivoy
AU - Alejandro Vargas-Moreno
AU - Maria Fernanda Rodríguez-Romero
AU - Oscar Hernando Feo-Lee
PY - 2026
DA - 2026/10/09
JO - Surgical neurology international
DO - 10.25259/sni_658_2026
UR - https://europepmc.org/article/MED/42974261
AB - Background Planum sphenoidale meningiomas (PSMs) and tuberculum sellae meningiomas (TSMs) represent a surgically challenging subset of anterior skull base tumors because of their close relationship with the optic apparatus, internal carotid arteries, anterior cerebral arteries, pituitary stalk, and hypothalamus. Although traditional anatomical distinctions have guided the choice between endoscopic endonasal and transcranial approaches (TCAs), increasing evidence suggests that individualized tumor-specific factors should drive surgical decision-making.Methods A narrative review of the literature was performed to evaluate anatomical considerations, classification systems, surgical approaches, outcomes, and complications associated with PSMs and TSMs. Evidence regarding transcranial, endoscopic endonasal, and minimally invasive approaches was synthesized to develop a practical decision-making framework.Results Contemporary literature shows that both transcranial and endoscopic endonasal approaches (EEAs) can achieve favorable outcomes when appropriately selected. TCAs remain advantageous for tumors with marked lateral extension, vascular encasement, or complex neurovascular relationships. EEAs may offer improved visualization of midline lesions, early devascularization, optic canal (OC) decompression, and favorable visual outcomes, although they are associated with a higher risk of cerebrospinal fluid leakage. Surgical experience, reconstruction techniques, tumor size, OC invasion, vascular involvement, and lateral extension are key determinants of outcome.Conclusion Management of PSMs and TSMs should be individualized rather than based solely on rigid anatomical classifications. The proposed algorithm integrates anatomical, radiological, and surgical factors to support approach selection and optimize patient outcomes.
SN - 2229-5097
SN - 2152-7806
ER -