Multimodal Evaluation and Endoscopic Endosnasal Management of a Suprasellar Meningioma: A Case Report

Suprasellar meningiomas account for 5–10% of intracranial meningiomas and commonly present with visual disturbances due to compression of the optic apparatus. The endoscopic endonasal approach (EEA) has emerged as a minimally invasive alternative to traditional transcranial approaches in selected cases. We report a case of a suprasellar mass presenting with visual symptoms. MRI revealed a well-defined, homogeneously enhancing lesion in the suprasellar region consistent with meningioma. The patient underwent endoscopic endonasal transplanum sphenoidal resection with successful tumor removal and optic decompression. Postoperative recovery was uneventful with no cerebrospinal fluid (CSF) leak. Recent literature emphasizes the importance of careful case selection for EEA. Radiological predictors such as absence of significant lateral extension, limited vascular encasement, and minimal hyperostosis favour successful endoscopic resection. Scoring systems incorporating cavernous internal carotid artery (ICA) involvement and dural tail extent help predict resectability. The present case met favourable criteria, correlating with good surgical outcome. EEA is a safe and effective approach for selected suprasellar meningiomas, offering excellent visual outcomes with minimal morbidity. Radiological assessment plays a crucial role in surgical planning and predicting outcomes.