Abstract
Objective: To evaluate the efficacy of combining an endonasal endoscopic skull-base approach and repair with a transcranial orbitozygomatic approach for spheno-orbital meningiomas (SOMs). Methods: Three patients with recurrent SOMs underwent combined orbitozygomatic and endonasal endoscopic surgery. In 2 patients both procedures were done in 1 operation and in 1 patient the endonasal surgery was done 2.5 months after the craniotomy. Extent of resection, complications, morbidity, and mortality were evaluated. Results: Gross total resection was achieved in 1 patient and near total resection in the other 2 patients with tumor left in the cavernous sinus and parapharyngeal space. Two patients suffered cranial neuropathy from the transcranial surgery and the other developed a pseudomeningocele. There were no complications from the endonasal surgery. Patients having combined single setting cranionasal surgery were discharged on day 6 and 8, whereas the patient having only the endonasal component on a later date was discharged on day 2. Conclusions: A combined cranionasal approach involving transcranial orbitozygomatic and endonasal endoscopic approaches is an effective 2-stage surgery for resecting SOMs invading into the sinuses and paranasal compartments. The ability to perform a multilayer closure involving a vascularized nasoseptal flap additionally decreases the risk of postoperative cerebrospinal fluid leak.
Original language | English |
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Pages (from-to) | e367-e373 |
Journal | World Neurosurgery |
Volume | 80 |
Issue number | 6 |
DOIs | |
State | Published - Dec 2013 |
Externally published | Yes |
Keywords
- Endoscopic endonasal
- Infratemporal fossa
- Paranasal sinuses
- Pterygopalatine fossa
- Skull base
- Spheno-orbital meningioma
- Transpterygoid approach
- Transsphenoidal approach