Suggestions
Idioma
Guide for authors
Searcher
Journal Information
Vol. 35. Issue 3.
Pages 113-168 (May - June 2024)
Cite
Cite
Share
Download PDF
More article options
Visits
1017
Vol. 35. Issue 3.
Pages 113-168 (May - June 2024)
Clinical Research

Minimally invasive approach for skull base meningiomas

Abordajes mínimamente invasivos para meningiomas de la base craneal
Visits
1017
Carlos Roberto Vargas Gálvez
Corresponding author
carlosvgg33@gmail.com

Corresponding author.
, Omar López Arbolay, Marlon Manuel Ortiz Machín
Servicio de Neurocirugía, Hospital “Hermanos Ameijeiras”, La Habana, Cuba
This item has received
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Abstract
Introduction

Skull base meningiomas constitute a complex group of skull base tumors. The endoscopic endonasal approaches (EEA) and endoscopic Keyhole have a minimally invasive philosophy with high effectiveness, safety, and a significant decrease in postoperative morbidity in these tumors.

Objective

To describe the results of the use of minimally invasive approaches to skull base meningiomas.

Method

A descriptive, retrospective study was carried out in 140 patients at the "Hermanos Ameijeiras" Hospital who underwent surgery for cranial base meningiomas using minimally invasive approaches to the cranial base. The degree of tumor resection, tumor recurrence, reinterventions, and complications were evaluated.

Results

ESA were used in 72.8% of the study, while endoscopic Keyholes were used in 26.4% and combined approaches in 0.7%. In relation to total tumor resection, 91.9% was generally achieved. Overall tumor recurrence and reinterventions were less than 8.5% and 4%, respectively. Complications in ESA were: cerebrospinal fluid (CSF) fistula (2.1%), diabetes insipidus, hydrocephalus, cerebral infarction, surgical site hematoma, worsening of cranial nerves I-IV (1.4%) respectively. While in the Keyhole type approaches: seizures (2.9%), hydrocephalus (1.4%), CSF fistula (1.4%), worsening of Nerves IX-XII (0.7%).

Conclusions

The following study reaffirms that minimally invasive approaches for skull base meningiomas constitute advanced surgical techniques for these tumors, associated with a low rate of postoperative complications.

Keywords:
Meningioma
Base of skull
Neuroendoscopy
Minimally invasive surgical procedures
Resumen
Introducción

Los meningiomas de la base craneal constituyen un grupo complejo de tumores en la base craneal. Los abordajes endonasales endoscópicos (AEE) y Keyhole endoscópicos poseen una filosofía mínimamente invasiva con elevada efectividad, seguridad y disminución significativa en la morbilidad posoperatoria en estos tumores.

Objetivo

Describir los resultados del empleo de los abordajes mínimamente invasivos a los meningiomas de la base craneal.

Método

Se realizó un estudio descriptivo, retrospectivo en 140 pacientes en el Hospital “Hermanos Ameijeiras” operados por meningiomas de la base craneal mediante abordajes mínimamente invasivos a la base craneal. Se evaluó el grado de resección tumoral, recurrencia tumoral, reintervenciones y complicaciones.

Resultados

Los AEE se emplearon en el 72,8% del estudio, mientras que los Keyhole endoscópicos en el 26,4% y abordajes combinados en el 0,7%. En relación a la resección tumoral total se alcanzó de forma general un 91,9. La recurrencia tumoral y reintervenciones de manera global fue inferior al 8,5% y 4%, respectivamente. Las complicaciones en los AEE fueron: fístula de líquido cefalorraquídeo (LCR) (2,1%), diabetes insípida, hidrocefalia, infarto cerebral, hematoma del sitio quirúrgico, empeoramiento de nervios craneales I-IV (1,4%) respectivamente. Mientras que en los abordajes tipo Keyhole: convulsiones (2,9%), hidrocefalia (1,4%), fístula de LCR (1,4%), empeoramiento de Nervios IX-XII (0,7%).

Conclusiones

El siguiente estudio reafirma que los abordajes mínimamente invasivos para los meningiomas de la base craneal constituyen técnicas quirúrgicas de avanzada para estos tumores, asociada a mínima tasa de complicaciones posoperatorias.

Palabras clave:
Meningioma
Base del cráneo
Neuroendoscopía
Procedimientos quirúrgicos mínimamente invasivos

Article

These are the options to access the full texts of the publication Neurocirugía (English edition)
Member
Member of the Sociedad Española de Neurocirugía

If it is the first time you have accessed you can obtain your credentials by contacting Elsevier Spain in suscripciones@elsevier.com or by calling our Customer Service at902 88 87 40 if you are calling from Spain or at +34 932 418 800 (from 9 to 18h., GMT + 1) if you are calling outside of Spain.

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option ¿I have forgotten my password¿.

Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to
Neurocirugía (English edition)
Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
References
[1]
M. Westphal, A. Saladino, M. Tatagiba.
Skull base meningiomas.
Adv Exp Med Biol., 1416 (2023), pp. 47-68
[2]
A.B. Todeschini, A. Beer-Furlan, B. Otto, D.M. Prevedello, R.L. Carrau.
Endoscopic endonasal approaches for anterior skull base meningiomas.
Adv Otorhinolaryngol., 84 (2020), pp. 114-123
[3]
I. Bove, S. Cheok, J.J. Ruzevick, G. Zada.
Endoscopic endonasal and keyhole surgery for skull base meningiomas.
Neurosurg Clin N Am., 34 (2023), pp. 393-402
[4]
C. Horbinski, T. Berger, R.J. Packer, P.Y. Wen.
Clinical implications of the 2021 edition of the WHO classification of central nervous system tumours.
Nat Rev Neurol., 18 (2022), pp. 515-529
[5]
C. Ogasawara, B.D. Philbrick, D.C. Adamson.
Meningioma: a review of epidemiology, pathology, diagnosis, treatment, and future directions.
[6]
E.D. Bander, H. Singh, C.B. Ogilvie, R.C. Cusic, D.J. Pisapia, A.J. Tsiouris, et al.
Endoscopic endonasal versus transcranial approach to tuberculum sellae and planum sphenoidale meningiomas in a similar cohort of patients.
J Neu-rosurg., 128 (2018), pp. 40-48
[7]
Y.C. Han, P.C. Sun, Z. Jiang, Z.M. Fan, H.B. Wang.
The surgical management of benign tumors of the lateral skull base with intracranial invasion: experience from a single centre over ten years.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi., 57 (2022), pp. 810-818
[8]
O. López, M. Ortiz, A. Coronado, A. Varela.
Consideraciones del abordaje keyhole endoscópico para tumores de la base craneal.
[9]
M. Ottenhausen, K. Rumalla, A.F. Alalade, P. Nair, E. La Corte, I. Younus, et al.
Decision-making algorithm for minimally invasive approaches to anterior skull base meningiomas.
Neurosurg Focus., 44 (2018), pp. E7
[10]
B. Brokinkel, D.C. Spille, C. Brokinkel, K. Hess, W. Paulus, E. Bormann, et al.
The Simpson grading: defining the optimal threshold for gross total resection in meningioma surgery.
Neurosurg Rev., 44 (2021), pp. 1713-1720
[11]
A. Kassam, C.H. Snyderman, A. Mintz, P. Gardner, R.L. Carrau.
Expanded endonasal approach: the rostrocaudal axis.
Part I. Crista galli to the sella turcica. Neurosurg Focus., 19 (2005), pp. E3
[12]
A. Kassam, C.H. Snyderman, A. Mintz, P. Gardner, R.L. Carrau.
Expanded en-donasal approach: the rostrocaudal axis. Part II. Posterior clinoids to the fo-ramen magnum.
Neurosurg Focus, 19 (2005), pp. E4
[13]
G. Hadad, L. Bassagasteguy, R.L. Carrau, J.C. Mataza, A. Kassam, C.H. Snyderman, et al.
A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap.
Laryngoscope., 116 (2006), pp. 1882-1886
[14]
D.Z. Khan, I.S. Muskens, R.A. Mekary, A.H. Zamanipoor Najafabadi, A.E. Helmy, R. Reisch, et al.
The endoscope-assisted supraorbital "keyhole" approach for anterior skull base meningiomas: an updated meta-analysis.
Acta Neurochir (Wien)., 163 (2021), pp. 661-676
[15]
N. Fatemi, J.R. Dusick, M.A. de Paiva Neto, D. Malkasian, D.F. Kelly.
Endonasal versus supraorbital keyhole removal of craniopharyngiomas and tuberculum sellae meningiomas.
Neurosurgery., 64 (2009), pp. 269-284
[16]
J.D. Thakur, R.J. Mallari, A. Corlin, S. Yawitz, W. Huang, A. Eisenberg, et al.
Minimally invasive surgical treatment of intracranial meningiomas in elderly patients (≥ 65 years): outcomes, readmissions, and tumor control.
Neurosurg Focus., 49 (2020), pp. E17
[17]
P.O. Champagne, E. Lemoine, M.W. Bojanowski.
Surgical management of giant sphenoid wing meningiomas encasing major cerebral arteries.
Neurosurg Focus., 44 (2018), pp. E12
[18]
C. Hayhurst, M.E. Sughrue, P.A. Gore, P.A. Bonney, J.D. Burks, C. Teo.
Results with expanded endonasal resection of skull base meningiomas technical nuances and approach selection based on an early experience.
Turk Neurosurg., 26 (2016), pp. 662-670
[19]
D. Aum, M.S. Rassi, O. Al-Mefty.
Petroclival meningiomas and the petrosal approach.
Handb Clin Neurol., 170 (2020), pp. 133-141
[20]
L. Giammattei, P. di Russo, D. Starnoni, T. Passeri, M. Bruneau, T.R. Meling, et al.
Petroclival meningiomas: update of current treatment and consensus by the EANS skull base section.
Acta Neurochir (Wien)., 163 (2021), pp. 1639-1663
[21]
H.W. Schroeder, A.K. Hickmann, J. Baldauf.
Endoscope-assisted microsurgical resection of skull base meningiomas.
Neurosurg Rev., 34 (2011), pp. 441-455
[22]
B.E. Youngerman, M.A. Banu, M.M. Gerges, E. Odigie, A. Tabaee, A. Kacker, et al.
Endoscopic endonasal approach for suprasellar meningiomas: introduction of a new scoring system to predict extent of resection and assist in case selection with long-term outcome data.
J Neurosurg., 135 (2020), pp. 113-125
[23]
M. Koutourousiou, J.C. Fernandez-Miranda, E.W. Wang, C.H. Snyderman, P.A. Gardner.
Endoscopic endonasal surgery for olfactory groove meningiomas: outcomes and limitations in 50 patients.
Neurosurg Focus., 37 (2014), pp. E8
[24]
E. Zanoletti, A. Mazzoni, A. Martini, R.V. Abbritti, R. Albertini, E. Alexandre, et al.
Surgery of the lateral skull base: a 50-year endeavour.
[25]
R.S. D’Amico, M.A. Banu, P. Petridis, A.S. Bercow, H. Malone, M. Praver, et al.
Efficacy and outcomes of facial nerve-sparing treatment approach to cerebellopontine angle meningiomas.
J Neurosurg., 127 (2017), pp. 1231-1241
Idiomas
Neurocirugía (English edition)
Article options
Tools