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Redi Rahmani, Madhav Sukumaran, Angela M. Donaldson, Olga Akselrod, Ehud Lavi, and Theodore H. Schwartz

.H.S.) between 2003 and 2013. Cases in which a xanthogranuloma was recorded in the pathology report were rereviewed by the neuropathologist to confirm the diagnosis. The demographic data, histological findings, operative reports, office record, and hospital notes were reviewed and patients were called to obtain the most recent follow-up. Results Over a 10-year period, 643 endonasal endoscopic procedures were performed in the sellar and parasellar area. Four (0.6%) were for xanthogranulomas, 43 (6.7%) were for CPs, and 13 (2%) were for RCCs. Case Reports Case 1

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Jason P. Sheehan, Robert M. Starke, Hideyuki Kano, Anthony M. Kaufmann, David Mathieu, Fred A. Zeiler, Michael West, Samuel T. Chao, Gandhi Varma, Veronica L. S. Chiang, James B. Yu, Heyoung L. McBride, Peter Nakaji, Emad Youssef, Norissa Honea, Stephen Rush, Douglas Kondziolka, John Y. K. Lee, Robert L. Bailey, Sandeep Kunwar, Paula Petti, and L. Dade Lunsford

resection and procedure-related morbidity and mortality. 2 , 6 , 21 , 28 , 40 , 46 , 50 , 58 Initial resection has also been associated with significant risks of delayed recurrence. 21 , 23 , 35 , 43 , 47 , 50 , 53 With earlier detection of sellar and parasellar meningiomas using MRI and/or CT, these tumors are now diagnosed when they have a small to moderate volume. Such tumors often produce minimal symptoms. Stereotactic radiosurgery has been advocated for recurrent sellar and parasellar meningiomas after resection or as an upfront treatment for others. 17 , 51 , 52

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Akio Noguchi, Vijayabalan Balasingam, Sean O. McMenomey, and Johnny B. Delashaw Jr.

S upraorbital craniotomy involves removal of the cranium superior to the orbital contents; this includes removal of the frontal bone, the supraorbital rim, and a portion of the orbital roof. This procedure provides surgical access to the orbit, the floor of the anterior fossa, and the parasellar region with minimal brain retraction. The concept was initially introduced as an extension of a subfrontal approach 6 in cases in which tumors do not invade the orbital roof. Previous descriptions of supraorbital craniotomy 4, 6 involved: 1) a bicoronal skin

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Vira Kasantikul, Samruay Shuangshoti, Pornyudh Preechayudh, and Somjai Wangsuphachart

I ntracranial neurilemmomas are most frequently found in the cerebellopontine angle since they usually arise from the acoustic nerve. 27, 31 They may originate from other cranial nerves, with the exception of the optic nerve, 1, 4, 7, 18–20, 26, 27, 30, 34 or they may arise in the leptomeninges. 29 Occasional neurilemmomas are combined with other mesenchymal tumors such as angiomas or meningiomas. 5, 16, 17 Several types of tumor are found in the sella turcica and parasellar regions, including pituitary adenomas, gliomas, meningiomas, and teratomas, 27

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Yasuhiro Yonekawa, Nobuyoshi Ogata, Hans-Georg Imhof, Magnus Olivecrona, Kevin Strommer, Tae Eon Kwak, Peter Roth, and Peter Groscurth

fissure and the optic canal, and, therefore, an extensive removal is possible. In contrast, when the intradural technique is used, both the extent of bone removal and the exposure that is gained tend to be limited. Second, the dura protects the intradural structures. Third, the procedure can be performed much more quickly than the intradural technique, because of the greater delicacy involved in performing the latter safely. We believe that most supra- and parasellar lesions are optimally managed by using our selective extradural anterior clinoidectomy. If there is

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Yoshikazu Ogawa and Teiji Tominaga

performed without discontinuation of antithrombotic therapy for comparison with the same number of transsphenoidal surgeries performed in the absence of antithrombotic therapy. Methods Between October 2008 and January 2014, 15 consecutive patients (11 males and 4 females; age range 51–75 years [mean 68.2 years]) with sellar and parasellar tumors were treated via a transsphenoidal approach by a single surgeon (Y.O.), accounting for 2.51% of all transsphenoidal operations during the same period. The histological diagnoses were pituitary adenoma (n = 9), Rathke's cleft

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Alexander S. G. Micko, Adelheid Wöhrer, Stefan Wolfsberger, and Engelbert Knosp

T he chances of complete resection and endocrinological remission (ER) of pituitary adenomas are reported to depend on their growth rate, size, 8 , 51 histological subtype, 3 , 46 and invasiveness into the surrounding structures. Special attention has been drawn to the endosteum of the sellar floor, the rate of histological invasion into which has been reported to be as high as 46%–85%. 52 , 62 Overt parasellar invasion into cavernous sinus (CS) structures is found intraoperatively in 6%–10% 1 , 20 of cases and is the most important reason for

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Wolfgang J. Weninger and Gerd B. Müller

A number of disease processes occur in the cavernous sinus region of neonates and young children. 2, 4, 6, 11, 15, 19, 46 These often require neurosurgical interventions, 33–36 treatment using invasive radiological techniques, 1, 5, 29, 40 or radiotherapy. 7, 9 All manipulations within this narrow space require an exact knowledge of the particular parasellar topography in infants. 33 However, all detailed descriptions of cavernous sinus anatomy, 3, 27, 31, 41, 42 measurements of important distances, 14, 20–22 and analyses of surgical approaches 8, 10, 18

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Yuichi Nagata, Tadashi Watanabe, Tetsuya Nagatani, Kazuhito Takeuchi, Jonsu Chu, and Toshihiko Wakabayashi

T he endoscopic transsphenoidal approach (eTSA) for parasellar lesions has become a standard neurosurgical procedure over the last decade. Many pituitary adenomas and other tumors arising at the parasellar region can be safely and completely resected via this approach. 3 , 4 , 6–8 , 10 , 12 , 13 , 16 , 17 , 31 , 37 , 39 However, some cases, which are fibrous, tightly adherent to critical structures, or extend far laterally beyond the internal carotid artery (ICA), are difficult to remove totally via this approach alone, or even through the transcranial approach

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Or Cohen-Inbar, Athreya Tata, Shayan Moosa, Cheng-chia Lee, and Jason P. Sheehan

M eningiomas are one of the most common types of intracranial tumors and account for 24%–33% of primary brain tumors. 9 , 55 The majority of meningiomas are WHO Grade I, thought to arise from arachnoidal cap cells, and are typically slow-growing, well-circumscribed lesions with benign histopathology. A safe and complete resection, when feasible, constitutes the preferred treatment modality. 7 , 8 , 46 The location of the tumor can significantly alter its clinical characteristics. In particular, parasellar meningiomas are a subset of skull base meningiomas in