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Updated: Sep 6, 2025
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Surgery for clinoidal meningiomas with cavernous sinus extension: Near-total excision and chiasmopexy
Daniele Starnoni1,2, Constantin Tuleasca3,4,5, Marc Levivier3,4
1Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Neurosurgery Service and Gamma Knife Center, Lausanne, Switzerland. Daniele.starnoni@chuv.ch.
Background:
The main factors limiting the extent of resection for clinoidal meningiomas are cavernous sinus extension and vessel adventitia involvement. The proximity to the optic apparatus and the risk of radiation-induced optic neuropathy often prevents many surgeons from proposing adjuvant radiosurgery.
Method:
We describe a simple technical solution that is to place a fat graft between the optic apparatus and the residual tumor to maintain the distance gained at surgery and facilitates the identification of anatomic structures.
Conclusion:
This technique allows to deliver optimal therapeutic doses to the residue reduces the dose received by the optic nerve below 8 Gy.
