• Tao Yang, Nan Zhang, DongXue Li, and ChengYu Xia.
• Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China; Department of Neurosurgery, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China.
• World Neurosurg. 2023 Jun 8.

ObjectiveAlthough 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).MethodsBetween 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.ResultsGTR 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.ConclusionsRetractorless 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.Copyright © 2023 Elsevier Inc. All rights reserved.

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