Minimally Invasive Approaches to Anterior Skull Base Meningiomas

Scott C Seaman; Muhammad S Ali; Anthony Marincovich; Luyuan Li; Jarrett E Walsh; Jeremy D. W Greenlee

doi:10.1055/s-0040-1716671

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Minimally Invasive Approaches to Anterior Skull Base Meningiomas

Journal article

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Minimally Invasive Approaches to Anterior Skull Base Meningiomas

Scott C Seaman, Muhammad S Ali, Anthony Marincovich, Luyuan Li, Jarrett E Walsh and Jeremy D. W Greenlee

Journal of neurological surgery. Part B, Skull base, Vol.83(3), pp.254-264

06/2022

DOI: 10.1055/s-0040-1716671

PMCID: PMC9236747

PMID: 35769807

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9236747View

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Abstract

Objective Anterior skull base meningiomas include olfactory groove, planum sphenoidale, and tuberculum sellae lesions. Traditionally, standard craniotomy approaches have been used to access meningiomas in these locations. More recently, minimally invasive techniques including supraorbital and endonasal endoscopic approaches have gained favor; however there are limited published series comparing the use of these two techniques for these meningiomas. Using our patent database, we identified patients who underwent these two approaches, and conducted a retrospective chart review to compare outcomes between these two techniques. Methods A total of 32 patients who underwent minimally invasive approaches were identified: 20 supraorbital and 11 endoscopic endonasal. Radiographic images, presenting complaints and outcomes, were analyzed retrospectively. The safety of each approach was evaluated. Results The mean extent of resection through a supraorbital approach was significantly greater than that of the endoscopic endonasal approach, 88.1 vs. 57.9%, respectively (p = 0.016). Overall, preoperative visual acuity and anopsia deficits were more frequent in the endonasal group that persisted postoperatively (visual acuity: p = 0.004; anopsia: p = 0.011). No major complications including cerebrospinal fluid (CSF) leaks or wound-related complications were identified in the supraorbital craniotomy group, while the endonasal group had two CSF leaks requiring lumbar drain placement. Length of stay was shorter in the supraorbital group (3.4 vs. 6.1 days, p < 0.001). Conclusion Anterior skull base meningiomas can be successfully managed by both supraorbital and endoscopic endonasal approaches. Both approaches provide excellent direct access to tumor in carefully selected patients and are safe and efficient, but patient factors and symptoms should dictate the approach selected.

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Details

Title: Subtitle: Minimally Invasive Approaches to Anterior Skull Base Meningiomas
Creators: Scott C Seaman - Department of Neurological Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
Muhammad S Ali - Department of Neurological Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
Anthony Marincovich - Department of Neurological Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
Luyuan Li - Department of Neurological Surgery, University of Iowa Hospitals and Clinics
Jarrett E Walsh - Department of Otolaryngology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
Jeremy D. W Greenlee - Department of Neurological Surgery, University of Iowa Hospitals and Clinics
Resource Type: Journal article
Publication Details: Journal of neurological surgery. Part B, Skull base, Vol.83(3), pp.254-264
DOI: 10.1055/s-0040-1716671
PMID: 35769807
PMCID: PMC9236747
NLM abbreviation: J Neurol Surg B Skull Base
ISSN: 2193-6331
eISSN: 2193-634X
Publisher: Georg Thieme Verlag KG
Language: English
Electronic publication date: 12/29/2020
Date published: 06/2022
Academic Unit: Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
Record Identifier: 9984068256002771

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