Recurrence of Anterior Skull Base Meningiomas After Endoscopic Endonasal Resection: 10 Years' Experience in a Series of 52 Endoscopic and Transcranial Cases

Bernat, Anne Laure; Priola, Stefano Maria; Elsawy, A.; Farrash, Faisal; Pasarikovski, Christopher R.; Almeida, João Paulo; Lenck, Stéphanie; Almeida, John de; Vescan, Allan; Monteiro, Eric; Zadeh, Gelareh; Gentili, Fred

doi:10.1016/j.wneu.2018.07.210

Cited by 12 publications

(14 citation statements)

References 30 publications

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“…Twentyeight OGM-only case series were included in the metaanalysis of which 5 involved EEA [4,28,62,70,92], 24 in mTCA [5,7,10,23,25,27,28,40,42,44,47,56,57,70,83,87,89,96,99,101,109,117,121,123], 3 in eSKA [4,39,92], and with 4 of these studies detailing multiple approaches [4,28,70,92]. Additionally, 15 studies explored both OGM and TSM [9,30,31,50,54,58,65,93,94,103,105,113,122,128,…”

Section: Search Resultsmentioning

confidence: 99%

“…Twenty-eight OGM-only case series were included in the meta-analysis of which 5 involved EEA [ 4 , 28 , 62 , 70 , 92 ], 24 in mTCA [ 5 , 7 , 10 , 23 , 25 , 27 , 28 , 40 , 42 , 44 , 47 , 56 , 57 , 70 , 83 , 87 , 89 , 96 , 99 , 101 , 109 , 117 , 121 , 123 ], 3 in eSKA [ 4 , 39 , 92 ], and with 4 of these studies detailing multiple approaches [ 4 , 28 , 70 , 92 ]. Additionally, 15 studies explored both OGM and TSM [ 9 , 30 , 31 , 50 , 54 , 58 , 65 , 93 , 94 , 103 , 105 , 113 , 122 , 128 , 129 ]. Resultantly, the TSM group totalled 2191 patients and OSM group totalled 1519 patients (Tables 1 and 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Importantly, studies that did not report specific outcomes for OGM/TSM and approach combination were excluded from the final meta-analysis. These studies were considered for qualitative analysis if the relevant the tumour (TSM or OGM) and approach (mTCA, EEA, or eSKA) combination of interest was > 50% of the study population [9,48,98,105,111]. Similarly, articles that grouped TSM cases with planum sphenoidale meningiomas [3,92] were considered for qualitative review only (owing to the similarity of these tumour groups) but not included in the final meta-analysis.…”

Section: Data Extractionmentioning

confidence: 99%

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The endoscope-assisted supraorbital “keyhole” approach for anterior skull base meningiomas: an updated meta-analysis

et al. 2020

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Introduction The gold-standard treatment for symptomatic anterior skull base meningiomas is surgical resection. The endoscope-assisted supraorbital "keyhole" approach (eSKA) is a promising technique for surgical resection of olfactory groove (OGM) and tuberculum sellae meningioma (TSM) but has yet to be compared with the microscopic transcranial (mTCA) and the expanded endoscopic endonasal approach (EEA) in the context of existing literature. Methods An updated study-level meta-analysis on surgical outcomes and complications of OGM and TSM operated with the eSKA, mTCA, and EEA was conducted using random-effect models. Results A total of 2285 articles were screened, yielding 96 studies (2191 TSM and 1510 OGM patients). In terms of effectiveness, gross total resection incidence was highest in mTCA (89.6% TSM, 91.1% OGM), followed by eSKA (85.2% TSM, 84.9% OGM) and EEA (83.9% TSM, 82.8% OGM). Additionally, the EEA group had the highest incidence of visual improvement (81.9% TSM, 54.6% OGM), followed by eSKA (65.9% TSM, 52.9% OGM) and mTCA (63.9% TSM, 45.7% OGM). However, in terms of safety, the EEA possessed the highest cerebrospinal fluid leak incidence (9.2% TSM, 14.5% OGM), compared with eSKA (2.1% TSM, 1.6% OGM) and mTCA (1.6% TSM, 6.5% OGM). Finally, mortality and intraoperative arterial injury were 1% or lower across all subgroups. Conclusions In the context of diverse study populations, the eSKA appeared not to be associated with increased adverse outcomes when compared with mTCA and EEA and offered comparable effectiveness. Case-selection is paramount in establishing a role for the eSKA in anterior skull base tumours.

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Section: Search Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Data Extractionmentioning

confidence: 99%

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The endoscope-assisted supraorbital “keyhole” approach for anterior skull base meningiomas: an updated meta-analysis

et al. 2020

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“…Another important and overlooked issue with reconstruction includes brain herniation into a large cribriform defect following EEA for OGM . Although brain herniation following EEA to OGM is indeed rare, it has been reported in a number of series and may have serious sequelae. Risk factors and management of this issue requires further investigation.…”

Section: Intradural Tumorsmentioning

confidence: 99%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

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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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“…Meticulous dissection of the optic nerves and chiasm, including careful preservation of small perforators to the optic apparatus, including the superior hypophyseal arteries, is required to prevent post-operative vision decline. Endoscopic endonasal series have reported worsening vision in up to 36%, with more recent series reporting much lower rates of less than 5% [Table 1] [11,13,23,24,26,[36][37][38][39][40][41][42][43][45][46][47][48][49][50][51] . CSF leaks from this approach are high flow (Grade 3 leaks) requiring a robust reconstruction, ideally with a nasoseptal flap.…”

Section: Complicationsmentioning

confidence: 99%

Endoscopic endonasal surgery for anterior skull base meningiomas

Avery¹,

Barkhoudarian²,

Kelly³

2021

MIS

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Meningiomas of the tuberculum sellae, planum sphenoidale and olfactory groove region are relatively common. Traditionally these meningiomas have been approached through several transcranial approaches. More recently, keyhole approaches have been utilized with success even for large tumors. Endoscopic approaches are an extension of this philosophy, which, in carefully selected patients, may be an excellent alternative, offering a direct line of site from an endonasal approach without brain retraction. Furthermore, bilateral optic canal decompression can be safely and effectively accomplished. We propose that a majority of tuberculum sellae and posterior planum meningiomas may be removed via an endonasal approach, particularly those that are 3 cm or smaller in maximal diameter with minimal lateral extension beyond the supraclinoid carotid arteries and with medial optic canal invasion. A deepened sella is also a favorable factor for endonasal removal. In contrast, we propose that a minority of olfactory groove meningiomas are ideal candidates for endoscopic trans-cribriform removal given the higher risk of anosmia and cerebrospinal fluid leak via the nasal corridor. Instead, a majority of these tumors can be safely and effectively removed via a transcranial keyhole approach, such as the supraorbital "eyebrow" craniotomy or traditional pterional craniotomy with a higher rate of olfaction preservation.

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Recurrence of Anterior Skull Base Meningiomas After Endoscopic Endonasal Resection: 10 Years' Experience in a Series of 52 Endoscopic and Transcranial Cases

Cited by 12 publications

References 30 publications

The endoscope-assisted supraorbital “keyhole” approach for anterior skull base meningiomas: an updated meta-analysis

The endoscope-assisted supraorbital “keyhole” approach for anterior skull base meningiomas: an updated meta-analysis

ICAR: endoscopic skull‐base surgery

Endoscopic endonasal surgery for anterior skull base meningiomas

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