The endonasal endoscopic transtuberculum transplanum approach is a safe and effective minimal access approach to midline pathology in the suprasellar cistern
((Mascarenhas L, Moshel YA, Bayad F, Szentirmai O, Salek AA, Leng LZ, Hofstetter
CP, Placantonakis DG, Tsiouris AJ, Anand VK, Schwartz TH. The Transplanum
Transtuberculum Approaches for Suprasellar and Sellar-Suprasellar Lesions:
Avoidance of Cerebrospinal Fluid Leak and Lessons Learned. World Neurosurg. 2013 
Feb 9. pii: S1878-8750(13)00297-0. doi: 10.1016/j.wneu.2013.02.032. [Epub ahead
of print] Review. PubMed PMID: 23403355.
)).

With the goal of gross-total tumor resection and visual improvement, [[endoscopic endonasal surgery]] (EES) can achieve very good results, (comparable to microscopic approaches) for the treatment of suprasellar [[meningioma]]s. Avoidance of [[brain]] and [[optic nerve]] retraction, preservation of the vascularization of the optic apparatus, and wide decompression of the [[optic canal]]s are the main advantages of EES for the treatment of suprasellar meningiomas, while [[cerebrospinal fluid leakage]] remain a disadvantage
((Koutourousiou M, Fernandez-Miranda JC, Stefko ST, Wang EW, Snyderman CH,
Gardner PA. Endoscopic endonasal surgery for suprasellar meningiomas: experience 
with 75 patients. J Neurosurg. 2014 Jun;120(6):1326-39. doi:
10.3171/2014.2.JNS13767. Epub 2014 Mar 28. PubMed PMID: 24678782.)).

Once the [[learning curve]] is overcome, endonasal endoscopic resection of suprasellar meningiomas can achieve high rates of gross total resection (GTR) with low complication rates in well-selected cases
((Ottenhausen M, Banu M, Placantonakis DG, Tsiouris AJ, Khan OH, Anand VK,
Schwartz TH. Endoscopic Endonasal Resection of Suprasellar Meningiomas: The
Importance of Case Selection and Experience in Determining Extent of Resection,
Visual improvement and Complications. World Neurosurg. 2014 Mar 19. pii:
S1878-8750(14)00280-0. doi: 10.1016/j.wneu.2014.03.032. [Epub ahead of print]
Review. PubMed PMID: 24657254.)).

===Interhemispheric approach====
The small bone window interhemispheric approach can be used to expose tumours, lightly stretch brain tissues, reduce the incidence of complications, and improve the total resection rate of tumours of patients with sellae meningiomas growing forward, upward, and into the sella
((Lu ZF, Cheng XB, Zhao YG, Shi BZ. Twenty-nine cases of resection of
suprasellar meningioma through small bone window: an interhemispheric approach.
Contemp Oncol (Pozn). 2013;17(6):525-9. doi: 10.5114/wo.2013.38913. Epub 2013 Dec
19. PubMed PMID: 24592141; PubMed Central PMCID: PMC3934039.)).