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Vol. 35. Issue 3.
Pages 127-135 (May - June 2024)
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Vol. 35. Issue 3.
Pages 127-135 (May - June 2024)
Clinical Research
Minimally invasive approach for skull base meningiomas
Abordajes mínimamente invasivos para meningiomas de la base craneal
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
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Tables (2)
Table 1. Distribution of patients according to sociodemographic, clinical, histopathological and imaging characteristics and approach type used (n = 140).
Table 2. Distribution of patients according to cranial fossa, tumour volume, location, approach, total and subtotal resection, recurrence, reoperation, disease-free time and complications (n = 140).
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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

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