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Updated: May 27, 2026
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
Evolution and future of skull base surgery: the paradigm of skull base meningiomas
Salvatore Di Maio1, Dinesh Ramanathan, Rabindranath Garcia-Lopez
1Department of Neurological Surgery, University of Washington, Harborview Medical Center, Seattle, Washington, USA.
Background:
Skull base meningiomas represent the paradigm for the evolution of skull base surgery within the past 50 years into a distinct neurosurgical subspecialty.
Methods:
From 2005 to 2011, 117 patients with cranial base meningiomas underwent surgical resection. Extent of resection, histologic grade, complications, functional status, and recurrence-free and overall survival data are presented.
Results:
The summary rate of gross total resection was 53.0%. The surgical complication and mortality rates were 17.9% and 0.9%, respectively. Five-year recurrence-free survival was 88.0% for grade I meningiomas. A total of 90.3% of patients had a Karnofsky performance score ≥ 80 at last follow-up.
Conclusions:
A large contemporary series of skull base meningiomas is presented. In addition, the evolution of surgical approaches to skull base meningiomas is reviewed, together with the current issues regarding radiation therapy, management of cavernous sinus tumor, oncologic management of atypical and malignant subtypes, molecular genetics, and future therapeutic options.
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