engleski

Minimally Invasive Approach to Anterior Fossa Meningiomas

Introduction : With the advent of modern neurosurgical era grounded on evolution of refined microsurgical instrumentation and techniques, illumination and magnification a shift toward minimal invasive approaches has been widely observed in the neurosurgical community. Even large intracranial pathology such as anterior fossa tumors can be accessed successfully via minimal invasive corridors such as supraorbital keyhole route. We report our experience and analyze the effectiveness of this particular approach for safe and complete removal of anterior fossa meningiomas. Material and Method : We analyzed our series of patients operated for anterior skull base meningiomas over a 12 year period via the supraorbital eyebrow keyhole approach. Demographic parameters, tumor location and size, extent of surgical resection, pre- and postoperative KPS and psychological test results are presented and discussed. We report the technical nuances of the procedure that based on our experience are of fundamental value for the safety and efficacy in applying this approach. Results : In the 2000-2012 period we used the supraorbital eyebrow keyhole approach in the treatment of 137 patients with anterior skull base meningiomas, of which there were 73 tuberculum sellae, 22 medial sphenoid wing, 28 frontobasal and 14 olfactory groove meningiomas. There were 104 females and 33 males, with age distribution between 16-79 (mean, 57.7). The size of tumors operated ranged from 1.3 to 6.2 cm in diameter. All lesions were radically removed at Simpson grade II. There were no statistically significant changes between preoperative and postoperative KPS scores or psychological test results. Conclusions : The supraorbital eyebrow keyhole approach had been adopted in our institution in 1996 and has since been developed and refined so that today it represents the favored route in addressing various pathology of anterior cranial fossa. It is a safe approach for selected patients that precludes large exposures of bony and nervous structures.

Minimally invasive; Keyhole; Meningeoma

nije evidentirano