Endoscopic Assisted Supraorbital Keyhole Approach or Endoscopic Endonasal Approach in Cases of Tuberculum Sellae Meningioma: Which Surgical Route Should Be Favored?

World Neurosurgery
Stefan LinslerJoachim Oertel

Abstract

Keyhole approaches are under investigation for skull base tumor surgery. They are expected to have a low complication rate with the same successful resection rate compared with endoscopic endonasal procedures. In this study, we compare our current series of tuberculum sellae meningiomas resected via an endoscopic endonasal or microsurgical supraorbital keyhole approach. Between 2011 and 2016, 16 patients were treated using the supraorbital keyhole procedure and 6 patients received an endoscopic endonasal procedure. Both surgical techniques were analyzed and compared concerning complications, surgical radicality, endocrinologic, and ophthalmologic outcome and recurrences in patients' follow-up. The 2 different approaches yielded similar rates of gross total resection (endonasal 83% [5 of 6] vs. supraorbital 87% [14 of 16]), near total resection (17% [1 of 6] vs. 13% [2 of 16]), and visual recovery (endonasal 66% [2 of 3] vs. supraorbital 60% [3 of 5]). An extension lateral to the internal carotid artery was noted in 81% (13 of 16) of the supraorbital cases and in none of the endonasal cases. Tumor volume was 14.9 cm(3) (±8.2 cm(3)) for supraorbital tumors versus 2.1 cm(3) (±0.8 cm(3)) for the endonasal approach. Both approaches ...Continue Reading

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Citations

Feb 1, 2019·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Philipp HendrixJoachim Oertel
Jul 23, 2019·International Forum of Allergy & Rhinology·Eric W WangCarl H Snyderman
Sep 19, 2019·Neurosurgical Review·Joachim OertelStefan Linsler
Mar 17, 2019·Acta neurochirurgica·Stefan LinslerSteffi Urbschat
Apr 25, 2021·Annals of Anatomy = Anatomischer Anzeiger : Official Organ of the Anatomische Gesellschaft·Sebastian SengerJoachim Oertel
May 4, 2021·Annals of Anatomy = Anatomischer Anzeiger : Official Organ of the Anatomische Gesellschaft·Stefan LinslerJoachim M Oertel
Aug 13, 2021·Journal of Neurological Surgery. Part A, Central European Neurosurgery·Pier Paolo MattognoGiannantonio Spena
Nov 15, 2021·World Neurosurgery·Zoe M RobinowKiarash Shahlaie
Jun 26, 2021·Neurology India·Awadhesh Kumar JaiswalPawan Kumar Verma

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