How I do it: endoscopic endonasal resection of tuberculum sellae meningioma.

BACKGROUND Tuberculum sellae meningiomas (TSMs) adherent to neurovascular structures are particularly challenging lesions requiring delicate and precise microneurosurgery. There is an ongoing debate about the optimal surgical approach. METHOD We describe technical nuances and challenges in TSM resection using the endoscopic endonasal approach (EEA) in two cases of fibrous tumors with adherence to neurovascular structures. The cases are illustrated with a video (case 1) and figures (cases 1 and 2). CONCLUSION A dedicated team approach and precise microsurgical technique facilitate safe resection of complex TSMs through the EEA.