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Step-by-Step Approach to the Suprasellar Region 7

Surgical Correlation


Step-by-step approach to the suprasellar region. The dura of the prechiasmatic sulcus has been opened, exposing the suprasellar cistern, and the sellar dura has also been opened to expose the pituitary gland. The superior intercavernous sinus has not been transected yet. 45-degree scissors are being used to transect the limbus dural fold just medial to the falciform ligament. This is a key surgical maneuver that dettaches the falciform ligament and provides access to the posterior-most aspect of the optic canal, where most tuberculum sella meningiomas invade. (Image courtesy of JC Fernandez-Miranda)