Endoscopic endonasal approach for a tuberculum sellae meningioma with optic canal involvement

The endoscopic endonasal approach has emerged as an effective and minimally invasive technique for the management of tuberculum sellae meningiomas. A 53-year-old woman with progressive visual deterioration due to a tuberculum sellae meningioma extending into the optic canal underwent endoscopic endonasal resection with optic canal decompression. Gross-total removal was achieved using a "French-door" dural opening and angled dissection, resulting in Simpson grade II resection with the preservation of neurovascular structures. Optic canal opening enabled safe tumor removal and significant visual improvement. Reconstruction employed sutured fascia lata grafts and a sphenoid sinus mucosal flap resulted in no postoperative cerebrospinal fluid leakage. The video can be found here: https://stream.cadmore.media/r10.3171/2025.10.FOCVID25151.