How I do it: contralateral supraorbital approach for tuberculum sellae meningioma.

Background: The resection of tuberculum sellae meningiomas poses a challenge particularly when dealing with the medial aspect of the optic nerve. Dissection of the tumor off the optic nerve is usually carried out in the blind spot "behind" the optic nerve. We describe a contralateral approach for asymmetric tuberculum sellae meningiomas, allowing direct visualization of the medial optic nerve. Method: Contralateral lateral supraorbital approach was performed, and complete tumor resection was achieved without any injury to the optic nerve.

Conclusion: The contralateral approach for asymmetric tuberculum sellae meningioma is an efficient technique allowing improved visualization of the medial optic nerve.