Endoscopic Assisted Supraorbital Keyhole Approach or Endoscopic Endonasal Approach in Cases of Tuberculum Sellae Meningioma: Which Surgical Route Should Be Favored?

Linsler, Stefan; Fischer, Gerrit; Skliarenko, Volodymyr; Stadie, Axel; Oertel, Joachim

doi:10.1016/j.wneu.2017.05.023

Cited by 62 publications

(86 citation statements)

References 52 publications

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“…Five additional papers, featuring analyses of TCA (n = 121) vs EEA (n = 87), demonstrated a rate of vision improvement ranging from 33.3% to 97.7% for those undergoing EEA, with a weighted average rate of vision improvement equaling 82.8%. In contrast, the rate of vision improvement in the TCA group ranged from 18.8% to 61.4%, with a weighted average rate of vision improvement equaling 44.6% (Table , Table ) . In 1 study, multivariate analysis, patient age less than 55 years old, and use of EEA were found to be associated with significantly higher odds of vision improvement …”

Section: Intradural Tumorsmentioning

confidence: 93%

“…In contrast, 7 series not including use of a vascularized NSF demonstrated an overall leak rate of 22.2% among 97 patients . Five papers reported CSF leak rates following TCA (n = 121) for tuberculum sellae meningiomas . The associated CSF leak rate ranged from 0.0% to 8.3% with an overall leak rate of 4.1%.…”

Section: Intradural Tumorsmentioning

confidence: 98%

“…reported leak rates of 25.0% and 69.2%, respectively, prior to the use of vascularized NSFs, though these rates dramatically decreased to 0.0% and 16.1%, respectively, following the use of a vascularized flap for closure. Improved leak rates over time likely reflect greater experience with use of vascularized flaps over the surgical learning curve . In contrast, 7 series not including use of a vascularized NSF demonstrated an overall leak rate of 22.2% among 97 patients .…”

Section: Intradural Tumorsmentioning

confidence: 99%

“…In contrast, the rate of GTR following TCA ranged from 22.2% to 87.5%, with a weighted average rate of GTR equaling 74.3% (Table , Table ) …”

Section: Intradural Tumorsmentioning

confidence: 99%

“…Five additional papers featured analyses of patients treated via TCA (n = 109) vs EEA (n = 71) . Within these papers, the rate of EEA GTR ranged from 50.0% to 85.7% with a weighted average rate of GTR equaling 76.3% (Table , Table ).…”

Section: Intradural Tumorsmentioning

confidence: 99%

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ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

157

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: 93%

Section: Intradural Tumorsmentioning

confidence: 98%

Section: Intradural Tumorsmentioning

confidence: 99%

“…In contrast, the rate of GTR following TCA ranged from 22.2% to 87.5%, with a weighted average rate of GTR equaling 74.3% (Table , Table ) …”

Section: Intradural Tumorsmentioning

confidence: 99%

Section: Intradural Tumorsmentioning

confidence: 99%

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ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

157

279

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Perioperative olfactory dysfunction in patients with meningiomas of the anteromedial skull base

et al. 2019

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Olfactory dysfunction represents a main symptom in olfactory groove meningiomas (OGM). Besides this, olfactory function has been sparsely investigated in patients suffering from supratentorial meningiomas. Here, the authors explore pre‐ and postoperative variables associated with olfactory dysfunction in supratentorial meningioma patients. This is a retrospective study on supratentorial meningioma patients who underwent meningioma resection between January 2015 and January 2016. Preoperative and postoperative olfactory performance was quantified using a lateralized sniffin' stick odor identification test. Meningiomas affecting the olfactory system (n = 23) were compared to meningiomas in other locations among the control group (n = 40). Meningiomas that affected the olfactory system had odds of 3.6 and 3.7 in being associated with ipsilateral (lesional) and bilateral anosmia, respectively. Subgroup analysis revealed that meningiomas causing a midline shift across the frontal base and older age represented risk factors for preoperative anosmia. The odds of experiencing acquired postoperative ipsilateral anosmia were significantly increased in olfactory system affecting meningiomas (OR 11.1). Subgroup analysis highlighted OGMs to represent the predominant location associated with deterioration. General surgical complications predisposed patients to loss of contralateral (OR 12.3) and bilateral olfactory function (OR 27.8). Older age and meningiomas causing a midline shift across the frontal base predispose patients to preoperative olfactory dysfunction. Resection of OGMs and surgical complications are risk factors for postoperative olfactory deterioration to anosmia. Likely, olfactory dysfunction is underrecognized even in OGMs. In OGM surgery, however, preoperative lateralized testing might be critical to selecting an appropriate surgical route to preserve olfactory function. Clin. Anat. 32:524–533, 2019. © 2019 Wiley Periodicals, Inc.

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Anterior Fossa: Eyebrow Keyhole Approach

Marx

Schroeder

2022

Contemporary Skull Base Surgery

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Endoscopic Assisted Supraorbital Keyhole Approach or Endoscopic Endonasal Approach in Cases of Tuberculum Sellae Meningioma: Which Surgical Route Should Be Favored?

Cited by 62 publications

References 52 publications

ICAR: endoscopic skull‐base surgery

ICAR: endoscopic skull‐base surgery

Perioperative olfactory dysfunction in patients with meningiomas of the anteromedial skull base

Anterior Fossa: Eyebrow Keyhole Approach

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