A clinical series evaluating tailored endoscopic endonasal routes to PitNETs extending through the oculomotor triangle into the parapeduncular space.

Zhu, Xiao, Yang, Liu, Li and colleagues analyzed 72 patients and compared two endonasal corridors. The transsupra-interclinoid route achieved a higher gross-total resection rate than the conventional transoculomotor route, but at the cost of a higher rate of immediate postoperative oculomotor palsy. Recovery rates were similar between groups.

The authors propose using the relationship between the size of the parapeduncular component and the tumor neck to tailor corridor selection.

Why it matters

This paper is directly relevant to the lateral limits of the endoscopic endonasal approach. It provides clinically useful data on the trade-off between extent of resection and cranial nerve morbidity in tumors extending beyond the cavernous sinus toward the parapeduncular space.

Reference

Zhu H, Xiao Z, Yang J, Liu C, Li C, et al.
Tailored endoscopic endonasal transoculomotor triangle approach for pituitary neuroendocrine tumors invading the parapeduncular space through the oculomotor triangle.
Journal of Neurosurgery. Published online September 18, 2026.
DOI: 10.3171/2026.4.JNS252128
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