Related Experiment Video
Updated: Apr 22, 2026
07:43
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
18.5K
Extended endoscopic transsphenoidal approach infrachiasmatic corridor
Savas Ceylan1, Ihsan Anik, Kenan Koc
1Neurosurgery Department, Medical Faculty, Pituitary Research Centre, Kocaeli University, Umuttepe Yerleşkesi Eski, İstanbul Yolu 10. Km, 41380 Umuttepe, İzmit, Kocaeli, Turkey, ssceylan@yahoo.com.
Neurosurgical Review
|October 11, 2014
Summary
The infrachiasmatic corridor offers a safe, inferior endoscopic route for skull base surgery. This approach facilitated tumor removal and improved visual function in selected patients.
Area of Science:
- Neurosurgery
- Skull Base Surgery
- Endoscopic Endonasal Surgery
Background:
- Extended endoscopic transsphenoidal approaches are necessary for skull base lesions extending to the suprasellar region.
- The infrachiasmatic corridor, formed by the basal arachnoid and Liliequist's membranes, provides an inferior surgical pathway.
- This corridor extends from the optic canal and tuberculum sella to the corpus mamillare.
Purpose of the Study:
- To evaluate the efficacy and safety of the extended endoscopic transsphenoidal approach using the infrachiasmatic corridor for middle midline skull base lesions.
- To assess the outcomes, including tumor resection rates and functional improvements, in patients undergoing this surgical technique.
Main Methods:
- A retrospective analysis of 52 patients who underwent an extended endoscopic transsphenoidal approach utilizing the infrachiasmatic corridor.
- Procedures included resection of tuberculum sella meningiomas, craniopharyngiomas, Rathke's cleft cysts, pituitary adenomas, and other midline skull base tumors.
- Outcomes assessed included extent of resection, improvement in visual deficits, and postoperative complications such as cerebrospinal fluid (CSF) leakage and diabetes insipidus.
Main Results:
- Total resection was achieved in 74% of tuberculum sella meningiomas (17/23) and 10/16 craniopharyngiomas.
- Of 20 patients with visual disorders, 14 showed improvement after surgery for meningiomas.
- Postoperative complications included CSF leakage (2 cases) and diabetes insipidus (1 transient, 1 permanent).
Conclusions:
- The infrachiasmatic corridor provides an effective and safer inferior surgical route for the endoscopic removal of selected middle midline skull base lesions.
- This approach demonstrates favorable outcomes for specific tumors like tuberculum sella meningiomas and craniopharyngiomas, with significant potential for visual recovery.
