Sinonasal Outcomes following Endoscopic Endonasal Resection of Anterior Skull Base Meningiomas: Surgical Experience and Outcome Evaluation

2015 ◽  
Vol 76 (S 01) ◽  
Author(s):  
Mihir Gupta ◽  
Omar Choudhri ◽  
Arjun Pendharkar ◽  
Abdullah Feroze ◽  
Abdulrazag Ajlan ◽  
...  
Keyword(s):  
Skull Base ◽  
Outcome Evaluation ◽  
Anterior Skull Base ◽  
Surgical Experience ◽  
Endoscopic Endonasal ◽  
Skull Base Meningiomas

Residual and Recurrent Disease Following Endoscopic Endonasal Approach as a Reflection of Anatomic Limitation for the Resection of Midline Anterior Skull Base Meningiomas

2021 ◽  
Author(s):  
Pradeep Setty ◽  
Juan C Fernandez-Miranda ◽  
Eric W Wang ◽  
Carl H Snyderman ◽  
Paul A Gardner
Keyword(s):  
Optic Nerve ◽  
Skull Base ◽  
Retrospective Chart Review ◽  
Residual Tumor ◽  
Average Diameter ◽  
Anterior Skull Base ◽  
Endoscopic Endonasal ◽  
Olfactory Groove ◽  
Orbital Roof ◽  
Skull Base Meningiomas

Abstract BACKGROUND Endoscopic endonasal approaches (EEAs) to anterior skull base meningiomas have grown in popularity, though anatomic limitations remain unclear. OBJECTIVE To show the anatomic limits of EEA for meningiomas. METHODS Retrospective chart review for all patients that underwent EEA for anterior skull base meningiomas from 2005 to 2014. RESULTS A total of 100 patients averaged follow-up of 46.9 mo (24-100 mo). A total of 35 patients (35%) had olfactory groove, 33 planum sphenoidale (33%), and 32 tuberculum sella (32%) meningiomas. The average diameter was 2.9 cm (0.5-8.1 cm). Vascular encasement was seen in 11 patients (11%) and calcification in 20 (20%). Simpson Grade 1 (SG1) resection was achieved in 64 patients (64%). Only calcification impacted degree of resection (40% SG1, P = .012). The most common residual was on the anterior clinoid dura (11 patients [11%]). Six (6%) had residual superior/lateral to the optic nerve. Residual tumor was adherent to the optic apparatus or arteries in 5 patients (5%) each, and 3 patients (3%) had residual lateral to the mid-orbit. Rates of residual decreased over time. A total of 11 patients (11%) had tumor recurrence (mean of 40 mo): 4 (4%) on the anterior clinoid, 2 (2%) each on the lateral orbital roof, adherent to optic apparatus and superolateral to the optic nerve, and 1 (1%) was at the anterior falx. CONCLUSION Anterior skull base meningiomas can effectively be approached via EEA in most patients; tumors extending to the anterior clinoid, anterior falx, or superolateral to the optic nerve or orbital roof, especially if calcified, may be difficult to reach via EEA.

Endoscopic Endonasal Resection of Anterior Skull Base Meningiomas

2012 ◽  
Vol 147 (3) ◽  
pp. 575-582 ◽  
Author(s):  
Vikram Padhye ◽  
Yuresh Naidoo ◽  
Hamish Alexander ◽  
Stephen Floreani ◽  
Simon Robinson ◽  
...  
Keyword(s):  
Skull Base ◽  
Anterior Skull Base ◽  
Endoscopic Endonasal ◽  
Skull Base Meningiomas

scholarly journals Endoscopic endonasal resection of skull base meningiomas: the significance of a “cortical cuff” and brain edema compared with careful case selection and surgical experience in predicting morbidity and extent of resection

2014 ◽  
Vol 37 (4) ◽  
pp. E7 ◽  
Author(s):  
Osaama H. Khan ◽  
Vijay K. Anand ◽  
Theodore H. Schwartz ◽  
Keyword(s):  
Skull Base ◽  
Brain Edema ◽  
Extent Of Resection ◽  
Gross Total Resection ◽  
Surgical Experience ◽  
Total Resection ◽  
Endoscopic Endonasal ◽  
Case Selection ◽  
Skull Base Meningiomas ◽  
Group 1

Object This paper describes a consecutive series of skull base meningiomas resected using an endoscopic endonasal approach through various corridors at a single institution over 7 years. The impact of case selection and experience, the presence of a cortical cuff between the tumor and surrounding vessels, and brain edema on morbidity and rates of gross-total resection (GTR) were examined. Methods A retrospective review of a series of 46 skull base meningiomas from a prospective database was conducted. The series of cases were divided by location: olfactory groove (n = 15), tuberculum and planum (n = 20), sellar/cavernous (n = 9) and petroclival (n = 2). Gross-total resection was never intended in the sellar/cavernous tumors, which generally invaded the cavernous sinus. Clinical charts, volumetric imaging, and pathology were reviewed to assess the extent of resection and complications. Cases were divided based on a time point in which surgical technique and case selection improved into Group 1 (surgery prior to June 2008; n = 21) and Group 2 (surgery after June 2008; n = 25) and into those with and without a cortical cuff and with and without brain edema. Results Improved case selection had the greatest impact on extent of resection. For the entire cohort, rates of GTR went from 38% to 76% (p = 0.02), and for cases in which GTR was the intent, the rates went from 63% to 84% (not significant), which was mostly driven by the planum and tuberculum meningiomas, which went from 75% to 91.7 % (nonsignificant difference). The presence of a cortical cuff and brain edema had no impact on outcomes. There were 3 CSF leaks (6.5%) but all were in Group 1. Hence, CSF leak improved from 14.2% to 0% with surgical experience. Lessons learned for optimal case selection are discussed. Conclusions Surgical outcome for endonasal endoscopic resection of skull base meningiomas depends mostly on careful case selection and surgical experience. Imaging criteria such as the presence of a cortical cuff or brain edema are less important.

Endoscopic Endonasal Approaches for Anterior Skull Base Meningiomas

2020 ◽  
pp. 114-123
Author(s):  
Alexandre B. Todeschini ◽  
André Beer-Furlan ◽  
Brad Otto ◽  
Daniel M. Prevedello ◽  
Ricardo L. Carrau
Keyword(s):  
Skull Base ◽  
Anterior Skull Base ◽  
Endoscopic Endonasal ◽  
Skull Base Meningiomas
Sign in / Sign up

Export Citation Format

Share Document