Surgical nuances of the expanded endoscopic anterior skull base craniectomy for hyperostotic meningioma resection
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Published on: July 5, 2021
Giuliano Silveira-Bertazzo1, Sunil Manjila2, Nyall R London3,4,5
1Department of Neurological Surgery, The Ohio State University Medical Center, N-1049 Doan Hall, 410 West 10th, Avenue, Columbus, OH, 43210, USA.
Background:
The rostral expanded endoscopic approach (EEA) to anterior cranial fossa (ACF) has several advantages over transcranial/craniofacial surgery, providing early access to the vascular supply of tumors and reducing morbidities of craniotomy especially that of brain retraction. This article presents endoscopic landmarks and nuances for a wide ACF corridor, with stepwise image-guided dissections highlighting surgical tricks and techniques to enhance surgical safety.
Methods:
We describe an expanded endoscopic endonasal anterior skull base craniectomy for a recurrent large olfactory groove hyperostotic meningioma, with correlated cadaveric dissections.
Conclusion:
The widening of rostral EEA can provide a safe and feasible route to access ACF. This article highlights the specific landmarks in endoscopic anatomy with reference to the angle of visualization and bayonetted instruments.
