Extended endonasal endoscopic approach for anterior midline skull base lesions

Özer, Mehmet İlker; Kutlay, Ahmet Murat; Durmaz, Mehmet Ozan; Kirik, Alparslan; Yaşar, Soner; Tehli, Özkan; Kural, Cahit; Temiz, Nail Çağlar; Durmaz, Abdullah; Ezgü, Mehmet Can; Daneyemez, Mehmet; İzci, Yusuf

doi:10.1016/j.clineuro.2020.106024

Cited by 2 publications

(1 citation statement)

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“…16 Liu and colleagues noted that early in their experience they based their surgical approach on the lateral extent of the OGM, and at that time 1 cm lateral to the lamina papyracea was seen as a limit for the extended EEA among members of the skull base community. 16,40,41 However, tumors this lateral were found to be difficult to excise via EEA alone and so Liu and colleagues began performing the SOKC for OGMs extending laterally and achieved successful outcomes (along with olfactory preservation). 42,43 Of note, the extended endonasal approaches came about during the evolution of the concept of team skull base surgery.…”

Section: Bilateral Versus Unilateral Approachesmentioning

confidence: 99%

Surgical Approaches to Resection of Olfactory Groove Meningiomas: Comparative Meta-analysis of the Endoscopic Endonasal versus Transcranial and Unilateral versus Bilateral Approaches

Brown,

Pennington,

Patel

et al. 2024

J Neurol Surg B Skull Base

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Here we systematically review the extant literature to highlight the advantages of bilateral versus unilateral approaches and endoscopic endonasal (midline) approaches versus transcranial approaches for olfactory groove meningiomas, focusing on complications, extent of resection, and local recurrence rates. Methods Three databases were queried to identify all primary prospective trials and retrospective series comparing outcomes following endoscopic endonasal versus transcranial approaches and unilateral versus bilateral craniotomy for surgical resection of olfactory groove meningiomas. All articles were screened by two independent authors and selected for formal analysis according to predefined inclusion/exclusion criteria. Results: Seven studies comprising 288 total patients (mean age 55.0 ± 24.6 years) met criteria for inclusion. In the three comparing the endoscopic endonasal (n=21) versus transcranial (n=32) approaches, there was no significant difference between the two with respect to gross total resection (p=0.34) or rates of Simpson Grade 1 resection (p=0.69). EEA demonstrated higher rates of overall complications (p<0.01) including postoperative infection (p=0.03). In the four studies comparing bilateral (n=117) versus unilateral approaches (n=118), overall complication rates (p<0.01) and disease recurrence (p=0.01) were higher with bilateral approaches. All surgery-related mortalities also occurred in the bilateral cohort (n=7, 7.14%). Gross total resection (p=0.63) and Simpson grade (p=0.48) were comparable between approaches. Olfaction preservation was superior for unilateral approaches (p<0.01). Conclusions Though the literature is limited, current evidence suggests that the EEA may be favorable over conventional craniotomy for select olfactory groove meningioma patients. Where craniotomy is used, unilateral approaches appear to reduce complications and the risk of olfaction loss

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