Paramedian tuberculum sellae meningioma: tumor resection and optic canal unroofing via contralateral supraorbital eyebrow approach.

Tuberculum sellae meningioma (TSM) causes disproportionate vision loss due often to an associated bony hypertrophy or an intradural tumor invasion into the optic canals. Several surgical approaches are available for resecting the TSMs. A contralateral transcranial approach from the side of better/normal vision may be beneficial in asymmetrical TSMs. It allows a favorable angle of attack and access to the medial wall of the affected optic canal. Here, the authors demonstrate the technique of a contralateral supraorbital eyebrow approach (c-SOA) that could be useful in a specific subset of TSMs with good oncological and cosmetic outcome. The video can be found here: https://stream.cadmore.media/r10.3171/2025.10.FOCVID25166.