AIM:Midline anterior skull base meningiomas include olfactory groove meningiomas (OGMs), Tuberculum Sellae meningiomas (TSMs), and planum sphenoidale meningiomas (PSMs). The main surgical challenge in treating these lesions is to excise the tumor totally without causing mortality or morbidity. Studying the clinical patterns and the surgical outcomes of these lesions. MATErIAL and METHods:Thirty cases of midline anterior skull base lesions were included in our study. Patients were operated upon by four routes: (i) unilateral subfrontal, (ii) bilateral subfrontal, (iii) frontotemporal approach, and (iv) bifrontal basal interhemispheric. Extent of resection was classified according to the Simpson grading system. The functional outcome of the patients was assessed by comparing the preoperative and the postoperative neurological examination, as well as the Karnofsky performance scale. rEsuLTs:We had 14 OGMs (46.7%), 9 TSMs (30%), and 7 PSMs (23.3%). The most commonly utilized approach was the subfrontal approach (unilateral or bilateral) in 80% of the cases, followed by the pterional approach in 16.6% of the cases. Total removal was achieved in 86.7% of the cases; subtotal excision was achieved in 13.3% of the cases. 41.2% of our cases showed postoperative clinical improvement. We had two mortalities in our study, representing 6.7%. We did not detect any tumor recurrences in our follow up. The median preoperative Karnofsky scale was 85, while the median postoperative Karnofsky scale was 90.CoNCLusIoN: Midline anterior skull base lesions are becoming amenable for total surgical excision with minimal morbidities and mortalities. Most preferred surgical routes are the subfrontal and the pterional approaches.KEywords: Olfactory groove meningiomas, Planum sphenoidale meningiomas, Tuberculum sellae meningiomas, Simpson grade ÖZ AMAÇ: Orta hat anterior kafa kaidesinin menenjiyomları olfaktör oluk menenjiyomları (OOM'ler), tüberkulum sella menenjiyomları (TSM'ler) ve planum sfenoidale menenjiyomları (PSM'leri) içerir. Bu lezyonların tedavisindeki ana cerrahi zorluk tümörün herhangi bir mortalite veya morbiditeye neden olmadan tümüyle eksizyonudur. Bu lezyonların klinik paternleri ve cerrahi sonuçları çalışılmıştır. yÖNTEM ve GErEÇLEr: Çalışmaya otuz orta hat anterior kafa kaidesi lezyonu dahil edilmiştir. Hastalar dört yolla ameliyat edilmiştir: (i) ünilateral subfrontal, (ii) bilateral subfrontal, (iii) frontotemporal yaklaşım ve (iv) bifrontal bazal interhemisferik. Rezeksiyon kapsamı Simpson derecelendirme sistemine göre sınıflandırılmıştır. Hastaların işlevsel sonucu preoperatif ve postoperatif nörolojik muayenenin ve Karnofsky performans ölçeği sonuçlarının karşılaştırılmasıyla değerlendirilmiştir.BuLGuLAr: 14 OOM (%46,7), 9 TSM (%30) ve 7 PSM (%23,3) mevcuttur. En sık kullanılan yaklaşım, olguların %80'inde kullanılan subfrontal yaklaşım (unilateral veya bilateral) olmuş ve bunu olguların %16,6'sında pterional yaklaşım takip etmiştir. Total eksizyon olguların %86,7'sinde ve subtotal eksizyon %13,3'ünde elde ed...
The free-hand technique of OC screw placement is a safe and viable option for occipitocervical fixation and may be a preferred alternative in selected cases. However, further studies are needed to compare its safety and reliability to other more established methods.
The main advantage of the telovelar approach is the early identification and preservation of the brain stem and PICA and in addition it allow for assessment of potential tumour attachment at the aforementioned areas.The perspective of the telovelar approach should be directed towards the advantage of early identification and preservation of the brain stem and PICA and in addition it allow for assessment of potential tumour attachment at the aforementioned areas.
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