Single surgeon experience with minimally invasive supraorbital craniotomy versus bifrontal craniotomy for anterior skull base meningiomas

Scott Christopher Seaman; Muhammad Salman Ali; Anthony Marincovich; Carlos Osorno-Cruz; Jeremy D W Greenlee

doi:10.25259/SNI_767_2020

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Single surgeon experience with minimally invasive supraorbital craniotomy versus bifrontal craniotomy for anterior skull base meningiomas

Journal article

Open access

Single surgeon experience with minimally invasive supraorbital craniotomy versus bifrontal craniotomy for anterior skull base meningiomas

Scott Christopher Seaman, Muhammad Salman Ali, Anthony Marincovich, Carlos Osorno-Cruz and Jeremy D W Greenlee

Surgical neurology international, Vol.11, p.458

2020

DOI: 10.25259/SNI_767_2020

PMCID: PMC7771486

PMID: 33408943

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https://doi.org/10.25259/SNI_767_2020View

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Abstract

Anterior skull base meningiomas (ASBMs) account for about 10% of meningiomas. Bifrontal craniotomy (BFC) represents the traditional transcranial approach to accessing meningiomas in these locations. Supraorbital craniotomy (SOC) provides a minimally invasive subfrontal corridor in select patients. Here, we present our series of ASBM accessed by SOC and BFC by a single surgeon to review decision-making and compare outcomes in both techniques. Thirty-three patients were identified with ASBM. Age, tumor characteristics, presenting symptoms, postoperative complications, and outcomes were analyzed. Bifrontal and SOC were performed in 13 and 20 patients, respectively. Mean follow-up time was 98.4 months. Patients undergoing SOC had smaller tumor size, located farther from the posterior table of frontal sinus, had less peritumoral edema, and decreased length of stay compared to patients undergoing BFC. Extent of resection was slightly better with BFC (99.8%) compared to SOC (91.8%), although this difference did not reach statistical significance. Recurrence-free survival and rate of re-do surgeries were not different between two groups. BFC was associated with higher rates of postoperative encephalomalacia. SOC provides an excellent surgical option for ASBMs providing comparable extent of resection, minimal manipulation of brain, and excellent cosmetic outcomes for patients. The patient selection is key to maximize the benefits from this approach.

Anterior skull base case series

Keyhole approaches

Supraorbital craniotomy

Meningioma

Bifrontal craniotomy

Details

Title: Subtitle: Single surgeon experience with minimally invasive supraorbital craniotomy versus bifrontal craniotomy for anterior skull base meningiomas
Creators: Scott Christopher Seaman - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, United States
Muhammad Salman Ali - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, United States
Anthony Marincovich - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, United States
Carlos Osorno-Cruz - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, United States
Jeremy D W Greenlee - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, United States
Resource Type: Journal article
Publication Details: Surgical neurology international, Vol.11, p.458
DOI: 10.25259/SNI_767_2020
PMID: 33408943
PMCID: PMC7771486
NLM abbreviation: Surg Neurol Int
ISSN: 2152-7806
eISSN: 2229-5097
Language: English
Date published: 2020
Academic Unit: Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
Record Identifier: 9984093889902771

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