Endoscopic glabellar approach to the anterior skull base: a technical note

Area of Science:

• Neurosurgery
• Minimally Invasive Surgery
• Endoscopic Techniques

Background:

• Anterior skull base tumors, such as olfactory groove meningiomas, often require complex surgical approaches.
• Traditional craniotomies can involve significant morbidity and prolonged recovery periods.

Observation:

• This study reports on an endoscopic glabellar transethmoidal approach, a novel minimally invasive technique for anterior skull base access.
• The procedure involves a small (3-cm) national skin incision and a limited frontonasal craniotomy (2x2 cm).
• Tumor removal is performed endoscopically after ethmoidectomy, with reconstruction of the dura and bone using grafts and titanium mesh.

Findings:

• The endoscopic glabellar transethmoidal approach was successfully applied in two patients with olfactory groove meningiomas.
• Key steps include interruption of ethmoidal arteries, endoscopic tumor resection, and multi-layer reconstruction.
• Observed benefits include enhanced patient recovery due to the minimally invasive nature of the technique.

Implications:

• This endoscopic technique represents a promising alternative for treating anterior skull base pathologies, potentially reducing surgical trauma.
• Further research may explore the long-term outcomes and broader applicability of this approach in neurosurgery.
• The findings suggest that minimally invasive endoscopic methods can achieve effective tumor resection with improved patient outcomes.