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Minimally invasive nummular approach to a giant meningioma of the anterior fossa
BACKGROUND: Several approaches are described for giant meningiomas of the anterior skull base. Recently, endonasal endoscopic approaches have been described as a minimally invasive (MI) alternative. However, the extension of dissection of the nose cavity and the risks of CSF leak do not fit in the M...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Scientific Scholar
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9168338/ https://www.ncbi.nlm.nih.gov/pubmed/35673653 http://dx.doi.org/10.25259/SNI_1246_2021 |
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author | Mandel, Mauricio Correa Bastianon Santiago, Raphael Augusto da Silva, Igor Araújo Ferreira |
author_facet | Mandel, Mauricio Correa Bastianon Santiago, Raphael Augusto da Silva, Igor Araújo Ferreira |
author_sort | Mandel, Mauricio |
collection | PubMed |
description | BACKGROUND: Several approaches are described for giant meningiomas of the anterior skull base. Recently, endonasal endoscopic approaches have been described as a minimally invasive (MI) alternative. However, the extension of dissection of the nose cavity and the risks of CSF leak do not fit in the MI prerogatives. We present an operative video illustrating a MI transcortical approach through a nummular craniotomy for a giant meningioma of the anterior fossa. CASE DESCRIPTION: We report an 83-year-old female patient. On neurological examination, she was drowsy and hemiparetic on the left side. MRI scan demonstrated a giant anterior fossa lesion (7.6 × 6.2 × 6 cm). An 1.5 diameter craniotomy was placed in the right frontal region after MRI 3D reconstruction analysis. The first step was to debulk the core of the tumor with the ultrasonic aspirator. An important aspect is that the surgeon needs to rotate its positions around the patient in a 360° fashion for a total resection. The final step was to inspect the surgical cavity with the endoscope to check for any remaining tumor. The patient was discharged home 1 day after the surgery with no new deficits. CONCLUSION: Giant meningiomas of the anterior fossa are a different entity. When they reach the cortical surface, the surgical approach can be different from the common skull base meningiomas. We demonstrate that a MI transcortical approach can be a safe alternative for giant meningiomas, especially for high-risk patients, as the elderly ones. |
format | Online Article Text |
id | pubmed-9168338 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Scientific Scholar |
record_format | MEDLINE/PubMed |
spelling | pubmed-91683382022-06-06 Minimally invasive nummular approach to a giant meningioma of the anterior fossa Mandel, Mauricio Correa Bastianon Santiago, Raphael Augusto da Silva, Igor Araújo Ferreira Surg Neurol Int Video Abstract BACKGROUND: Several approaches are described for giant meningiomas of the anterior skull base. Recently, endonasal endoscopic approaches have been described as a minimally invasive (MI) alternative. However, the extension of dissection of the nose cavity and the risks of CSF leak do not fit in the MI prerogatives. We present an operative video illustrating a MI transcortical approach through a nummular craniotomy for a giant meningioma of the anterior fossa. CASE DESCRIPTION: We report an 83-year-old female patient. On neurological examination, she was drowsy and hemiparetic on the left side. MRI scan demonstrated a giant anterior fossa lesion (7.6 × 6.2 × 6 cm). An 1.5 diameter craniotomy was placed in the right frontal region after MRI 3D reconstruction analysis. The first step was to debulk the core of the tumor with the ultrasonic aspirator. An important aspect is that the surgeon needs to rotate its positions around the patient in a 360° fashion for a total resection. The final step was to inspect the surgical cavity with the endoscope to check for any remaining tumor. The patient was discharged home 1 day after the surgery with no new deficits. CONCLUSION: Giant meningiomas of the anterior fossa are a different entity. When they reach the cortical surface, the surgical approach can be different from the common skull base meningiomas. We demonstrate that a MI transcortical approach can be a safe alternative for giant meningiomas, especially for high-risk patients, as the elderly ones. Scientific Scholar 2022-05-06 /pmc/articles/PMC9168338/ /pubmed/35673653 http://dx.doi.org/10.25259/SNI_1246_2021 Text en Copyright: © 2022 Surgical Neurology International https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Video Abstract Mandel, Mauricio Correa Bastianon Santiago, Raphael Augusto da Silva, Igor Araújo Ferreira Minimally invasive nummular approach to a giant meningioma of the anterior fossa |
title | Minimally invasive nummular approach to a giant meningioma of the anterior fossa |
title_full | Minimally invasive nummular approach to a giant meningioma of the anterior fossa |
title_fullStr | Minimally invasive nummular approach to a giant meningioma of the anterior fossa |
title_full_unstemmed | Minimally invasive nummular approach to a giant meningioma of the anterior fossa |
title_short | Minimally invasive nummular approach to a giant meningioma of the anterior fossa |
title_sort | minimally invasive nummular approach to a giant meningioma of the anterior fossa |
topic | Video Abstract |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9168338/ https://www.ncbi.nlm.nih.gov/pubmed/35673653 http://dx.doi.org/10.25259/SNI_1246_2021 |
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