TY - JOUR
T1 - Endoscopic Endonasal Resection of Anterior Skull Base Meningiomas
AU - Padhye, Vikram
AU - Naidoo, Yuresh
AU - Alexander, Hamish
AU - Floreani, Stephen
AU - Robinson, Simon
AU - Santoreneos, Steve
AU - Wickremesekera, Agadha
AU - Brophy, Brian
AU - Harding, Marguerite
AU - Vrodos, Nikitas
AU - Wormald, Peter
PY - 2012/9
Y1 - 2012/9
N2 - Objective. Anterior cranial fossa (ACF) meningiomas are difficult to surgically manage. Endoscopic transnasal approaches have increasingly been used as a minimally invasive route and thus offer significant advantages. However, a paucity of literature describing the intraoperative challenges and postoperative outcomes of this technique still exists. Study Design. Case series with chart review. Setting. The Royal Adelaide Hospital, Flinders Medical Centre, Wellington Hospital. Subjects and Methods. Fifteen consecutive patients who underwent endoscopic resection of ACF meningiomas between 2004 and 2010 by the South Australian and Wellington Skull Base Units. Demographic and clinical information was compiled by reviewing patient charts and operation notes. Safety and efficacy of the procedure, role of a team approach, and areas for further improvement were analyzed. Results. Of the patients, 87% were women. Tumor locations: 8 olfactory groove, 2 tuberculum sellae, 1 clinoidal, 1 jugum sphenoidale, 1 planum sphenoidale, 1 subfrontal, and 1 midline ACF floor. Commonest presenting symptom was visual change. Mean volume of tumor was 25.69 cm3, with a size area of 7.28 cm2. Five were revision cases. None had previous endonasal surgery. Average operating times decreased over time. Gross total removal was achieved in 14, with no deaths. Four patients had postoperative cerebrospinal fluid (CSF) leak. Rate of CSF leak decreased over time. Sixty percent of patients reported visual improvement. Two patients had radiological evidence of recurrence. Conclusion. ACF meningiomas can be safely removed endonasally, offering significant advantages over the traditional transcranial approach for suitable tumors. Early audit of this approach shows results achieved by this unit are comparable with the published literature.
AB - Objective. Anterior cranial fossa (ACF) meningiomas are difficult to surgically manage. Endoscopic transnasal approaches have increasingly been used as a minimally invasive route and thus offer significant advantages. However, a paucity of literature describing the intraoperative challenges and postoperative outcomes of this technique still exists. Study Design. Case series with chart review. Setting. The Royal Adelaide Hospital, Flinders Medical Centre, Wellington Hospital. Subjects and Methods. Fifteen consecutive patients who underwent endoscopic resection of ACF meningiomas between 2004 and 2010 by the South Australian and Wellington Skull Base Units. Demographic and clinical information was compiled by reviewing patient charts and operation notes. Safety and efficacy of the procedure, role of a team approach, and areas for further improvement were analyzed. Results. Of the patients, 87% were women. Tumor locations: 8 olfactory groove, 2 tuberculum sellae, 1 clinoidal, 1 jugum sphenoidale, 1 planum sphenoidale, 1 subfrontal, and 1 midline ACF floor. Commonest presenting symptom was visual change. Mean volume of tumor was 25.69 cm3, with a size area of 7.28 cm2. Five were revision cases. None had previous endonasal surgery. Average operating times decreased over time. Gross total removal was achieved in 14, with no deaths. Four patients had postoperative cerebrospinal fluid (CSF) leak. Rate of CSF leak decreased over time. Sixty percent of patients reported visual improvement. Two patients had radiological evidence of recurrence. Conclusion. ACF meningiomas can be safely removed endonasally, offering significant advantages over the traditional transcranial approach for suitable tumors. Early audit of this approach shows results achieved by this unit are comparable with the published literature.
KW - endonasal meningioma
KW - endoscopic meningioma
KW - skull base meningioma
UR - http://www.scopus.com/inward/record.url?scp=84870415525&partnerID=8YFLogxK
U2 - 10.1177/0194599812446565
DO - 10.1177/0194599812446565
M3 - Review article
SN - 0194-5998
VL - 147
SP - 575
EP - 582
JO - Otolaryngology-Head and Neck Surgery
JF - Otolaryngology-Head and Neck Surgery
IS - 3
ER -