Top

Published in:

01-11-2016 | Topic Review

Microsurgical resection of skull base meningioma—expanding the operative corridor

Authors: Amol Raheja, William T. Couldwell

Published in: Journal of Neuro-Oncology | Issue 2/2016

Abstract

A better understanding of surgical anatomy, marked improvement in illumination devices, provision of improved hemostatic agents, greater availability of more precise surgical instruments, and better modalities for skull base reconstruction have led to an inevitable evolution of skull base neurosurgery. For the past few decades, many skull base neurosurgeons have worked relentlessly to improve the surgical approach and trajectory for the expansion of operative corridor. With the advent of newer techniques and their rapid adaptation, it is foundational, especially for young neurosurgeons, to understand the basics and nuances of modifications of traditional neurosurgical approaches. The goal of this topic review is to discuss the evolution of, concepts in, and technical nuances regarding the operative corridor expansion in the field of skull base surgery for intracranial meningioma as they pertain to achieving optimal functional outcome.

Available only for authorised users

Spetzler RF, Sanai N (2012) The quiet revolution: retractorless surgery for complex vascular and skull base lesions. J Neurosurg 116:291–300CrossRefPubMed

Altay T, Couldwell WT (2012) The frontotemporal (pterional) approach: an historical perspective. Neurosurgery 71:481–491CrossRefPubMed

Mishra S, Srivastava AK, Kumar H, Sharma BS (2015) Reshaping the zygomatic complex: a “small step” in frontotemporal craniotomy and a “big leap” in exposure. Neurol India 63:723–726CrossRefPubMed

Pellerin P, Lesoin F, Dhellemmes P, Donazzan M, Jomin M (1984) Usefulness of the orbitofrontomalar approach associated with bone reconstruction for frontotemporosphenoid meningiomas. Neurosurgery 15:715–718CrossRefPubMed

Hakuba A, Tanaka K, Suzuki T, Nishimura S (1989) A combined orbitozygomatic infratemporal epidural and subdural approach for lesions involving the entire cavernous sinus. J Neurosurg 71:699–704CrossRefPubMed

Zabramski JM, Kiris T, Sankhla SK, Cabiol J, Spetzler RF (1998) Orbitozygomatic craniotomy. Technical note. J Neurosurg 89:336–341CrossRefPubMed

Gupta SK, Sharma BS, Pathak A, Khosla VK (2001) Single flap fronto-temporo-orbito-zygomatic craniotomy for skull base lesions. Neurol India 49:247–252PubMed

Tessier P, Guiot G, Derome P (1973) Orbital hypertelorism. II. Definite treatment of orbital hypertelorism (OR.H.) by craniofacial or by extracranial osteotomies. Scand J Plast Reconstr Surg 7:39–58CrossRefPubMed

Derome P (1972) Spheno-ethmoidal tumors. Possibilities for exeresis and surgical repair. Neurochirurgie 18(Suppl 1):1–164

10.

Feiz-Erfan I, Spetzler RF, Horn EM, Porter RW, Beals SP, Lettieri SC, Joganic EF, Demonte F (2008) Proposed classification for the transbasal approach and its modifications. Skull Base 18:29–47CrossRefPubMedPubMedCentral

11.

Feiz-Erfan I, Han PP, Spetzler RF, Horn EM, Klopfenstein JD, Porter RW, Ferreira MA, Beals SP, Lettieri SC, Joganic EF (2005) The radical transbasal approach for resection of anterior and midline skull base lesions. J Neurosurg 103:485–490CrossRefPubMed

12.

Liu JK, Decker D, Schaefer SD, Moscatello AL, Orlandi RR, Weiss MH, Couldwell WT (2003) Zones of approach for craniofacial resection: minimizing facial incisions for resection of anterior cranial base and paranasal sinus tumors. Neurosurgery 53:1126–1135CrossRefPubMed

13.

Liu J, Amini A, Orlandi R, Weiss M, Couldwell W (2010) The role of transsphenoidal surgery in the management of complex lesions involving the skull base. In: Laws E, Lanzino G (eds) Transsphenoidal surgery. Elsevier, Philadelphia

14.

Kawase T, Shiobara R, Toya S (1991) Anterior transpetrosal-transtentorial approach for sphenopetroclival meningiomas: surgical method and results in 10 patients. Neurosurgery 28:869–875CrossRefPubMed

15.

Cho CW, Al-Mefty O (2002) Combined petrosal approach to petroclival meningiomas. Neurosurgery 51:708–716CrossRefPubMed

16.

Tripathi M, Deo RC, Suri A, Srivastav V, Baby B, Kumar S, Kalra P, Banerjee S, Prasad S, Paul K, Roy TS, Lalwani S (2015) Quantitative analysis of the Kawase versus the modified Dolenc–Kawase approach for middle cranial fossa lesions with variable anteroposterior extension. J Neurosurg 123:14–22CrossRefPubMed

17.

Heros RC (1986) Lateral suboccipital approach for vertebral and vertebrobasilar artery lesions. J Neurosurg 64:559–562CrossRefPubMed

18.

Bertalanffy H, Seeger W (1991) The dorsolateral, suboccipital, transcondylar approach to the lower clivus and anterior portion of the craniocervical junction. Neurosurgery 29:815–821CrossRefPubMed

19.

Sen CN, Sekhar LN (1991) Surgical management of anteriorly placed lesions at the craniocervical junction–an alternative approach. Acta Neurochir (Wien) 108:70–77CrossRef

20.

George B, Dematons C, Cophignon J (1988) Lateral approach to the anterior portion of the foramen magnum. Application to surgical removal of 14 benign tumors: technical note. Surg Neurol 29:484–490CrossRefPubMed

21.

Suhardja A, Agur AM, Cusimano MD (2003) Anatomical basis of approaches to foramen magnum and lower clival meningiomas: comparison of retrosigmoid and transcondylar approaches. Neurosurg Focus 14(6):e9CrossRefPubMed

22.

Babu RP, Sekhar LN, Wright DC (1994) Extreme lateral transcondylar approach: technical improvements and lessons learned. J Neurosurg 81:49–59CrossRefPubMed

23.

Patel SK, Husain Q, Eloy JA, Couldwell WT, Liu JK (2012) Norman Dott, Gerard Guiot, and Jules Hardy: key players in the resurrection and preservation of transsphenoidal surgery. Neurosurg Focus 33(2):E6CrossRefPubMed

24.

Schmidt RF, Choudhry OJ, Takkellapati R, Eloy JA, Couldwell WT, Liu JK (2012) Hermann Schloffer and the origin of transsphenoidal pituitary surgery. Neurosurg Focus 33(2):E5CrossRefPubMed

25.

Couldwell WT, Weiss MH, Rabb C, Liu JK, Apfelbaum RI, Fukushima T (2004) Variations on the standard transsphenoidal approach to the sellar region, with emphasis on the extended approaches and parasellar approaches: surgical experience in 105 cases. Neurosurgery 55:539–547CrossRefPubMed

26.

Kouri JG, Chen MY, Watson JC, Oldfield EH (2000) Resection of suprasellar tumors by using a modified transsphenoidal approach. Report of four cases. J Neurosurg 92:1028–1035CrossRefPubMed

27.

Couldwell WT, Sabit I, Weiss MH, Giannotta SL, Rice D (1997) Transmaxillary approach to the anterior cavernous sinus: a microanatomic study. Neurosurgery 40:1307–1311CrossRef

28.

Kitano M, Taneda M (2001) Extended transsphenoidal approach with submucosal posterior ethmoidectomy for parasellar tumors. Technical note. J Neurosurg 94:999–1004CrossRefPubMed

29.

Sabit I, Schaefer SD, Couldwell WT (2000) Extradural extranasal combined transmaxillary transsphenoidal approach to the cavernous sinus: a minimally invasive microsurgical model. Laryngoscope 110:286–291CrossRefPubMed

30.

Spencer WR, Das K, Nwagu C, Wenk E, Schaefer SD, Moscatello A, Couldwell WT (1999) Approaches to the sellar and parasellar region: anatomic comparison of the microscope versus endoscope. Laryngoscope 109:791–794CrossRefPubMed

31.

Alfieri A (1999) Endoscopic endonasal transsphenoidal approach to the sellar region: technical evolution of the methodology and refinement of a dedicated instrumentation. J Neurosurg Sci 43:85–92PubMed

32.

Kassam AB, Prevedello DM, Carrau RL, Snyderman CH, Thomas A, Gardner P, Zanation A, Duz B, Stefko ST, Byers K, Horowitz MB (2011) Endoscopic endonasal skull base surgery: analysis of complications in the authors’ initial 800 patients. J Neurosurg 114:1544–1568CrossRefPubMed

33.

Harvey RJ, Parmar P, Sacks R, Zanation AM (2012) Endoscopic skull base reconstruction of large dural defects: a systematic review of published evidence. Laryngoscope 122:452–459CrossRefPubMed

34.

Bowers CA, Altay T, Couldwell WT (2011) Surgical decision-making strategies in tuberculum sellae meningioma resection. Neurosurg Focus 30(5):E1CrossRefPubMed

35.

Komotar RJ, Starke RM, Raper DM, Anand VK, Schwartz TH (2012) Endoscopic endonasal versus open transcranial resection of anterior midline skull base meningiomas. World Neurosurg 77:713–724CrossRefPubMed

Title: Microsurgical resection of skull base meningioma—expanding the operative corridor
Authors: Amol Raheja
William T. Couldwell
Publication date: 01-11-2016
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 2/2016
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-016-2197-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Microsurgical resection of skull base meningioma—expanding the operative corridor

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2016

The transsylvian approach for resection of insular gliomas: technical nuances of splitting the Sylvian fissure

Maximizing safe resection of low- and high-grade glioma

Microsurgical resection of vestibular schwannomas: complication avoidance

Resection of falx and parasagittal meningioma: complication avoidance

Endoscopic transnasal skull base surgery: pushing the boundaries

Microsurgical removal of craniopharyngioma: endoscopic and transcranial techniques for complication avoidance