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Pure endoscopic subfrontal keyhole approach for planum sphenoidale meningiomas and olfactory groove meningiomas

Hiroki Morisako1, Michael Lumintang Loe1,2,3, Rayford Hazunga1

  • 1Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.

Neurosurgical Focus: Video
|January 22, 2026
PubMed

Insights

A new purely endoscopic subfrontal keyhole approach (PESKA) offers a less invasive surgical option for planum sphenoidale meningiomas (PSMs) and olfactory groove meningiomas (OGMs), achieving gross-total resection with no new neurological deficits.

Area of Science:

  • Neurosurgery
  • Minimally Invasive Surgery
  • Neuro-oncology

Background:

  • Standard treatment for planum sphenoidale meningiomas (PSMs) and olfactory groove meningiomas (OGMs) is surgical resection.
  • Traditional transcranial and various minimally invasive endoscopic techniques are currently employed.

Purpose of the Study:

  • To describe a novel surgical technique, the purely endoscopic subfrontal keyhole approach (PESKA), for PSMs and OGMs.
  • To evaluate the efficacy and safety of PESKA in achieving gross-total resection.

Main Methods:

  • The study details the surgical procedure for the purely endoscopic subfrontal keyhole approach (PESKA).
  • PESKA utilizes an endoscope-assisted keyhole craniotomy for accessing PSMs and OGMs.

Main Results:

  • Gross-total resection was successfully achieved in all patients undergoing the PESKA procedure.
  • No new postoperative neurological symptoms were observed in the patient cohort.

Conclusions:

  • The purely endoscopic subfrontal keyhole approach (PESKA) is a viable and effective surgical technique for PSMs and OGMs.
  • PESKA enables smaller craniotomies and reduced surgical time, leading to decreased patient invasiveness.
Keywords:
olfactory groove meningiomasplanum sphenoidale meningiomaspure endoscopic keyhole approachsubfrontal approach

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