Minimally invasive approach for skull base meningiomas

• Published in: Neurocirugía (Barcelona. Internet. English ed.) 2024-05, Vol.35 (3), p.127-135
• Main Authors: Vargas Gálvez, Carlos Roberto, López Arbolay, Omar, Ortiz Machín, Marlon Manuel
• Format: Article
• Language: English
• Subjects: Base del cráneo; Base of skull; Meningioma; Minimally invasive surgical procedures; Neuroendoscopy; Neuroendoscopía; Procedimientos quirúrgicos mínimamente invasivos
• ISSN: 2529-8496; 2529-8496
• DOI: 10.1016/j.neucie.2023.11.002

Skull base meningiomas constitute a complex group of skull base tumors. The endoscopic endonasal approaches (EEA) and endoscopic Keyhole have a minimally invasive philosophy with high effectiveness, safety, and a significant decrease in postoperative morbidity in these tumors. To describe the results of the use of minimally invasive approaches to skull base meningiomas. A descriptive, retrospective study was carried out in 140 patients at the "Hermanos Ameijeiras" Hospital who underwent surgery for cranial base meningiomas using minimally invasive approaches to the cranial base. The degree of tumor resection, tumor recurrence, reinterventions, and complications were evaluated. ESA were used in 72.8% of the study, while endoscopic Keyholes were used in 26.4% and combined approaches in 0.7%. In relation to total tumor resection, 91.9% was generally achieved. Overall tumor recurrence and reinterventions were less than 8.5% and 4%, respectively. Complications in ESA were: cerebrospinal fluid (CSF) fistula (2.1%), diabetes insipidus, hydrocephalus, cerebral infarction, surgical site hematoma, worsening of cranial nerves I-IV (1.4%) respectively. While in the Keyhole type approaches: seizures (2.9%), hydrocephalus (1.4%), CSF fistula (1.4%), worsening of Nerves IX-XII (0.7%). The following study reaffirms that minimally invasive approaches for skull base meningiomas constitute advanced surgical techniques for these tumors, associated with a low rate of postoperative complications. Los meningiomas de la base craneal constituyen un grupo complejo de tumores en la base craneal. Los abordajes endonasales endoscópicos (AEE) y Keyhole endoscópicos poseen una filosofía mínimamente invasiva con elevada efectividad, seguridad y disminución significativa en la morbilidad posoperatoria en estos tumores. Describir los resultados del empleo de los abordajes mínimamente invasivos a los meningiomas de la base craneal. Se realizó un estudio descriptivo, retrospectivo en 140 pacientes en el Hospital “Hermanos Ameijeiras” operados por meningiomas de la base craneal mediante abordajes mínimamente invasivos a la base craneal. Se evaluó el grado de resección tumoral, recurrencia tumoral, reintervenciones y complicaciones. Los AEE se emplearon en el 72,8% del estudio, mientras que los Keyhole endoscópicos en el 26,4% y abordajes combinados en el 0,7%. En relación a la resección tumoral total se alcanzó de forma general un 91,9. La recurrencia tumoral y reintervenciones de manera glob