Comparison of endoscopic endonasal and bifrontal craniotomy approaches for olfactory groove meningiomas: A matched pair analysis of outcomes and frontal lobe changes on MRI

Almeida, John R. de; Carvalho, Felipe Gutiérrez; Vaz-Guimarães, Francisco; Kiehl, Tim Rasmus; Koutourousiou, Maria; Su, Shirley Y.; Vescan, Allan; Witterick, Ian J.; Zadeh, Gelareh; Wang, Eric; Fernández-Miranda, Juan C.; Gardner, Paul A.; Gentili, Fred; Snyderman, Carl H.

doi:10.1016/j.jocn.2015.03.056

Cited by 59 publications

(83 citation statements)

References 28 publications

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“…Although some studies suggest that the complication rates of EEA are higher than that of transcranial approaches, others suggest no significant difference between the 2 groups . In the 2 systematic reviews where comparison of postoperative complications between the EEA cohort and transcranial cranial cohort was made, no significant difference was found between the 2 groups excluding CSF leak.…”

Section: Intradural Tumorsmentioning

confidence: 99%

“…Eleven studies met our inclusion criteria, 4 of which were systematic reviews . Reviewed studies with clinical endpoints and conclusions are summarized in Table .…”

Section: Intradural Tumorsmentioning

confidence: 99%

“…Through the use of vascularized flaps, reconstruction of even large skull‐base defects rivals the closure rates in open surgery . Additionally, there is evidence that endoscopic approaches to skull‐base tumors may provide benefits in neurological, visual, and functional outcomes when compared to traditional open surgery . Finally, patients undergoing an endoscopic resection have been found to recover faster with shorter hospital stays postoperatively …”

Section: Sinonasal Malignanciesmentioning

confidence: 99%

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ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

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151

279

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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Section: Intradural Tumorsmentioning

confidence: 99%

“…Eleven studies met our inclusion criteria, 4 of which were systematic reviews . Reviewed studies with clinical endpoints and conclusions are summarized in Table .…”

Section: Intradural Tumorsmentioning

confidence: 99%

Section: Sinonasal Malignanciesmentioning

confidence: 99%

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ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

Self Cite

151

279

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“…Irrespective of the evolving surgical techniques and technologies, several principles hold true: sufficient bone should be removed to minimize excessive retraction and resultant injury of the brain; preservation, reconstruction, and mobilization vessels should be meticulous; neural structures should not be crossed, as much as possible; reconstruction and closure should be carefully planned; and a concerted effort should be made to remove the tumor during the first operation. 14,[26][27][28][29][30][31][32][33] With respect to selecting the appropriate surgical corridor (i.e., dorsal transcranial versus ventral endonasal) and pursuing a near total resection in the first operation, we believe that this can be critically dependent on the size, location, extension of the tumor, suspected grade and consistency, neurological deficits, and surgeon's experience and preference. In addition, recent evidence has suggested that the biological behavior and genetic makeup of meningiomas can influence outcomes of surgical resection.…”

Section: Rationale Of Multicorridor Approach For Olfactory Groove Menmentioning

confidence: 99%

The Role of 3D Tractography in Skull Base Surgery: Technological Advances, Feasibility, and Early Clinical Assessment with Anterior Skull Base Meningiomas

Chakravarthi

Fukui

Monroy-Sosa

et al. 2020

J Neurol Surg B Skull Base

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Objective The aim of this study is to determine feasibility of incorporating three-dimensional (3D) tractography into routine skull base surgery planning and analyze our early clinical experience in a subset of anterior cranial base meningiomas (ACM). Methods Ninety-nine skull base endonasal and transcranial procedures were planned in 94 patients and retrospectively reviewed with a further analysis of the ACM subset. Main Outcome Measures (1) Automated generation of 3D tractography; (2) co-registration 3D tractography with computed tomography (CT), CT angiography (CTA), and magnetic resonance imaging (MRI); and (3) demonstration of real-time manipulation of 3D tractography intraoperatively. ACM subset: (1) pre- and postoperative cranial nerve function, (2) qualitative assessment of white matter tract preservation, and (3) frontal lobe fluid-attenuated inversion recovery (FLAIR) signal abnormality. Results Automated 3D tractography, with MRI, CT, and CTA overlay, was produced in all cases and was available intraoperatively. ACM subset: 8 (44%) procedures were performed via a ventral endoscopic endonasal approach (EEA) corridor and 12 (56%) via a dorsal anteromedial (DAM) transcranial corridor. Four cases (olfactory groove meningiomas) were managed with a combined, staged approach using ventral EEA and dorsal transcranial corridors. Average tumor volume reduction was 90.3 ± 15.0. Average FLAIR signal change was –30.9% ± 58.6. 11/12 (92%) patients (DAM subgroup) demonstrated preservation of, or improvement in, inferior fronto-occipital fasciculus volume. Functional cranial nerve recovery was 89% (all cases). Conclusions It is feasible to incorporate 3D tractography into the skull base surgical armamentarium. The utility of this tool in improving outcomes will require further study.

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“…Several surgical approaches have been used to remove OGMs, with the pterional and subfrontal (unifrontal or bifrontal) approaches being the most popular, but designating the optimal surgical approach is still controversial (1,3,8,10,11,14,17,19,25,28,(32)(33)(34)36,37).…”

Section: █ Introductionmentioning

confidence: 99%

Pterional and unifrontal approach for the microsurgical resection of olfactory groove meningiomas: experience with a series of 61 consecutive patients

Güdük¹,

Yener²,

Sun³

et al. 2016

Turkish Neurosurgery

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ABSTRACTof tumor growth leading to large tumor sizes at the time of diagnosis (8,33,41). The differentiation from meningiomas of the planum sphenoidale and tuberculum sellae is of clinical and surgical importance; tumors arising from these sites are usually diagnosed at an early stage due to visual impairment, which is a late finding in OGMs (7,11,22,28).Anatomically, OGMs arise from the weakest part of the skull base, i.e. the cribriform plate, making them prone to infiltrate the underlying bone and extend into the paranasal sinuses and nasal cavity. This feature is rarely observed in planum █ INTRODUCTION O lfactory groove meningiomas (OGMs) account for 4-13% of all intracranial meningiomas. They originate from the dura of the anterior cranial fossa over the cribriform plate and frontosphenoidal suture (7,10,11,25,36).OGMs usually present with hypo/anosmia, visual deterioration, mental changes and headache as a result of olfactory or optic nerve and frontal lobe compression. Seizures are also common in these patients (8,33). However, these tumors grow slowly and usually remain clinically quiescent during the early phases AIM: Olfactory groove meningiomas make up 4 to 13% of meningiomas. The first line treatment of meningiomas is surgery, but the extent and types of approaches advised for olfactory groove meningiomas are diverse, from aggressive skull base approaches to standard or minimally invasive craniotomies and endoscopic approaches. We retrospectively reviewed our series of olfactory groove meningiomas that were operated microsurgically by standard pterional or unifrontal approaches. MATERIAL and METHODS:Our series of 61 olfactory groove meningioma patients operated through pterional or unifrontal approaches between March 1987 and September 2015 was reviewed and the clinical data, radiological findings, surgical treatment and clinical outcomes of the patients were retrospectively analyzed. RESULTS:Sixty-three craniotomies were performed in total. Pterional and unifrontal approaches were used in 38 (60.3%) and 25 (39.7%) surgical procedures, respectively. Overall, gross total tumor resection was achieved in 59 (93.7%) cases. Complications were seen in 8 cases, and 2 of these patients underwent reoperation. Three of the 4 patients where only subtotal resection could be achieved underwent gamma knife radiosurgery.CONCLUSION: Pterional and unifrontal approaches, which are familiar and standard for neurosurgeons, can accomplish high rates of total resection with acceptable complication and recurrence rates for the treatment of olfactory groove meningiomas.

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Comparison of endoscopic endonasal and bifrontal craniotomy approaches for olfactory groove meningiomas: A matched pair analysis of outcomes and frontal lobe changes on MRI

Cited by 59 publications

References 28 publications

ICAR: endoscopic skull‐base surgery

ICAR: endoscopic skull‐base surgery

The Role of 3D Tractography in Skull Base Surgery: Technological Advances, Feasibility, and Early Clinical Assessment with Anterior Skull Base Meningiomas

Pterional and unifrontal approach for the microsurgical resection of olfactory groove meningiomas: experience with a series of 61 consecutive patients

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