Tuberculum Sellae (Suprasellar) Meningiomas
The standard approach is via a frontotemporal or pterional craniotomy, with adequate anterior exposure to allow sufficient subfrontal exposure to gain access to the tumor along the upper part of the sphenoid wing. The side chosen is usually determined by the side on which the optic nerve is most compromised. Another approach, recently adopted in the authors' unit, is via a direct trans-glabella route passing through the frontal sinus. This involves minimal retraction and direct access and is uncomplicated provided that the sinus is adequately repaired. Olfactory tracts are preserved. (This is also suitable for the resection of olfactory groove meningiomas.) The blood supply comes mainly from meningeal vessels over the tuberculum, with little from the carotid. These tuberculum vessels should be taken first as the tumor is undermined. Internal decompression is performed prior to dissection from the vessels and optic apparatus.
Cavernous Sinus and Medial Sphenoid (Parasellar) Meningiomas The approach for cavernous sinus and medial sphenoid meningiomas is similar to the
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.