Table 3.

Pros and cons for each corridor for the management of tuberculum sellae meningiomas (TSM).

Corridor	Pros	Cons
Anterior Route
Bilateral subfrontal approach	short surgical corridor wide exposure management of the hyperostotic anterior skull base bone optic canals unroofing Better visualization in cases of large/giant tumors Exposure of optic nerves inferior surface and preservation of perforators	overexposure and significant retraction of the frontal lobes risk of CSF leak and meningitis due to the opening of frontal sinus superior sagittal sinus ligation bilateral frontal lobe retraction
Unilateral subfrontal approach	No superior sagittal sinus ligation No bilateral frontal lobe retraction No frontal sinus opening short surgical corridor wide exposure management of the hyperostotic anterior skull base bone optic canals unroofing Exposure of optic nerves in-ferior surface and preserva-tion of perforators
Anterior interhemispheric approach	symmetrical view and control of optic apparatus, ICAs and their branches No extensive retraction direct view of tumor postero-inferior extension	superior sagittal sinus and bridging veins sacrifice high rate of postoperative anosmia inadequate exposure of the tumor lateral margins
Anterolateral Route
Pterional approach and its variants	possibility to use both subfrontal and transsylvian routes lower rates of postoperative CSF leak preservation of the frontal sinus early CSF release early identification and protection of the neurovascular structures preservation of the olfaction	inadequate control of tumor extending in the ipsilateral optic canal and inferior surface of the chiasm
Ventral Route
Endonasal transplanum-transtuberculum approach	Early tumor devascularization direct exposure of the subchiasmatic area without brain retraction direct decompression of optic nerves straight control of the perforating vessels	high risk of postoperative CSF leak [33,41,42,43,44,45]

CSF: cerebrospinal fluid; ICA: internal carotid artery.