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The Endoscopic L-Shape Approach for Anterior Skull Base Meningiomas with Olfactory Preservation: A Technical Note
Abdulaziz S Alrasheed1, Ashwag Alqurashi2, Abdulrazag Ajlan3
1Department of Otolaryngology-Head & Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
World Neurosurgery
|December 9, 2024
Summary
This study introduces a modified endoscopic L-shaped approach for anterior skull base meningiomas, aiming to preserve olfaction. The technique successfully achieved gross total resection while maintaining olfactory function in a patient.
Area of Science:
- Neurosurgery
- Otolaryngology
- Endoscopic Skull Base Surgery
Background:
- Preserving olfaction during anterior skull base meningioma resection is challenging.
- Olfactory dysfunction significantly impacts quality of life.
Purpose of the Study:
- To present a modified endonasal endoscopic L-shaped approach.
- To maximize tumor resection while preserving olfaction.
Main Methods:
- Cadaveric dissection to refine the surgical technique.
- Application of the modified approach in a patient with planum sphenoidale meningioma.
Main Results:
- Gross total resection achieved with preservation of olfactory epithelium and bulb.
- Postoperative olfactory function assessed as hyposmia (5/8), with preserved function at 1-year follow-up.
- No tumor recurrence observed at 1 year.
Conclusions:
- The L-shaped modification offers effective exposure for endoscopic resection.
- Potential for preserving olfaction in anterior skull base meningioma surgery.
- Careful patient selection and planning are crucial for optimal outcomes.
Keywords:
Anterior skull base meningiomasEndonasal endoscopic approachesOlfactionTranscribriform approach
