title: Frontobasal Midline Meningiomas: Is It Right To Shed Doubt on the Transcranial Approaches? Updates and Review of the Literature.
abstract: BACKGROUND
  Traditionally, the surgical removal of tuberculum sellae meningioma (TSM) and olfactory groove meningioma (OGM) requires transcranial approaches and microsurgical techniques, but in the last decade endoscopic expanded endonasal approaches have been introduced: transcribriform for OGMs and transtuberculum-transplanum for TSM. A comparative analysis of the literature concerning the two types of surgical treatment of OGMs and TSM is, however, difficult.
  
  
  METHODS
  We conducted a literature search using the PubMed database to compare data for endoscopic and microsurgical techniques in the literature. We also conducted a retrospective analysis of selected cases from our series presenting favorable characteristics for an endoscopic approach, based on the criteria of operability of these lesions as generally accepted in the literature, and we compared the results obtained in these patients with those in the endoscopic literature.
  
  
  RESULTS
  We believe that making the sample more homogeneous, the difference between microsurgical technique and endoscopic technique is no longer so striking. A greater radical removal rate, a reduced incidence of cerebrospinal fluid fistula and, especially, the possibility of removing lesions of any size are advantages of transcranial surgery; a higher percentage of improvement in visual outcome and a lower risk of a worsening of a pre-existing deficit or onset of a new deficit are advantages of the endoscopic technique.
  
  
  CONCLUSIONS
  At present, the microsurgical technique is still the gold standard for the removal of the anterior cranial fossa meningiomas of all sizes, and the endoscopic technique remains a second option in certain cases.
authors.affiliation: Department of Neurology and Psychiatry, Neurosurgery Unit, Sapienza University of Rome, Rome, Italy.
authors.forename: Andrea Gennaro
authors.initials: AG
authors.lastname: Ruggeri
authors.affiliation: Department of Neurology and Psychiatry, Neurosurgery Unit, Sapienza University of Rome, Rome, Italy. Electronic address: cappelletti.marty@gmail.com.
authors.forename: Martina
authors.initials: M
authors.lastname: Cappelletti
authors.affiliation: Department of Neurology and Psychiatry, Neurosurgery Unit, Sapienza University of Rome, Rome, Italy.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Fazzolari
authors.affiliation: Department of Neurology and Psychiatry, Neurosurgery Unit, Sapienza University of Rome, Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Marotta
authors.affiliation: Department of Neurology and Psychiatry, Neurosurgery Unit, Sapienza University of Rome, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Delfini
mesh_terms: D006801:Humans; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D008579:Meningioma / Q000453:epidemiology* / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000706:statistics & numerical data; D044583:Neuroendoscopy / Q000706:statistics & numerical data; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D019292:Skull Base Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D016896:Treatment Outcome
keywords: Endoscopic removal; Microsurgical removal; Olfactory groove meningioma; Tuberculum sellae meningioma