Eka Julianta Wahjoepramono
Universitas Pelita Harapan

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Supraorbital Approach For Tuberculum Sellae Meningioma Diana Rela Oktaviani; Petra Octavian Perdana Wahjoepramono; Eka Julianta Wahjoepramono
Lumina : Indonesian Journal of Neurology Vol. 1 No. 3 (2025): December: Lumina: Indonesian Journal of Neurology
Publisher : Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/lijn.v1i3.10334

Abstract

Introduction: Tuberculum sellae meningiomas pose significant surgical challenges due to their proximity to critical neurovascular structures. Pterional craniotomy has been the conventional method for approaching anterior skull base lesions, while the supraorbital eyebrow approach has emerged as an alternative in selected cases.Case Presentation: We report the case of a 50-year-old woman with progressive left temporal hemianopia due to a tuberculum sellae meningioma. The tumor was resected via left supraorbital approach, achieving gross total resection. Estimated intraoperative blood loss 50 mL, and total operative time 185 minutes. Histopathological examination confirmed WHO Grade I meningioma. Postoperative recovery was uneventful. Contrast-enhanced brain MRI at 3-month follow-up showed no residual or recurrent tumor. Discussion: Surgical management of tuberculum sellae meningiomas is particularly challenging because of their proximity to critical structures. Conventional approaches provide wide exposure but require extensive soft tissue and bone manipulation. The supraorbital eyebrow approach offers a minimally invasive keyhole route. In our case, it allowed safe gross total resection, preservation of neurovascular function, and rapid postoperative recovery.Conclusion: This case highlights the feasibility, safety, and effectiveness of the supraorbital eyebrow approach for resecting anterior skull base meningiomas. Keywords: Anterior skull base surgery; Eyebrow craniotomy; Keyhole approach; Minimally invasive; Supraorbital approach; Tuberculum sellae meningioma