Turkish Neurosurgery 2016 , Vol 26 , Num 5
Results with Expanded Endonasal Resection of Skull Base Meningiomas Technical Nuances and Approach Selection Based on an Early Experience
Caroline HAYHURST1, Michael E. SUGHRUE2, Pankaj A. GORE3, Phillip A. BONNEY2, Joshua D. BURKS2, Charles TEO3
1University Hospital of Wales, Department of Neurosurgery, Cardiff, United Kingdom
2University of Oklahoma Health Sciences Center, Comprehensive Brain Tumor Center, Oklahoma City, OK, USA
3Prince of Wales Private Hospital, The Centre for Minimally Invasive Neurosurgery, Randwick, New South Wales, Australia
DOI : 10.5137/1019-5149.JTN.16105-15.3 AIM: Reconstruction technique advances have created renewed enthusiasm for the expanded endonasal approach (EEA). However, as with any new technique, early experiences inevitably lead to more selective use of these techniques. We reviewed our experience of the expanded endonasal endoscopic approach for skull base meningiomas and place it in context of the literature.

MATERIAL and METHODS: We performed retrospective review of all endonasal cases performed at our center for histologically proven meningioma. Tumor locations in 26 patients included the olfactory groove (n=9), tuberculum sellae (n=7), optic nerve sheath (n=1), planum sphenoidale (n=2), clival (n=1) petroclival (n=3), cavernous sinus (n=2) and extensive pan-basal meningioma (n=1).

RESULTS: The median follow-up was 38.6 months. Excluding 3 patients with tumors found incidentally, pre-operative symptoms improved in 14 of 23 (61%), were the same in 8 of 23 (35%) and worsened in one of 23 patients (4%) at time of last follow-up. Of all 26 patients, 16 (62%) had complete macroscopic resection of their tumor, 5 (19%) underwent at least 90% resection, and 5 (19%) underwent subtotal resection. There were two neurological complications and one cerebrospinal fluid leak.

CONCLUSION: This study presents outcomes of patients treated with endonasal endoscopic meningioma surgery. We believe that very low rates of morbidity can be achieved in carefully selected patients, thus avoiding brain manipulation. Keywords : Endoscopy, Expanded endonasal, Minimally invasive, Meningioma, Skull base

Corresponding author : Michael E. Sughrue, Michael-Sughrue@ouhsc.edu