Anterior skull base tumor resection by transciliary supraorbital keyhole craniotomy: a single institutional experience.

Anterior skull base tumor resection by transciliary supraorbital keyhole craniotomy: a single institutional experience.

World Neurosurg. 2018 Jan 08;:

Authors: Lin YJ, Chen KT, Lee CC, Toh CH, Wu TE, Huang YC, Hsu PW, Lu YJ, Chuang CC, Chen PY, Wei KC

Abstract
BACKGROUND: The prognosis and recurrence rate following resection of an anterior skull base lesion via transciliary supraorbital keyhole craniotomy depends on residual tumor volume. The extent to which pathology and size of tumor influence the resection rate using this approach is unknown.
METHODS: Sixty-two patients underwent a total of 64 operations using the supraorbital keyhole approach in this retrospective study. Meningioma was the most common tumor, followed by pituitary adenoma and craniopharyngioma. Age, gender, tumor volume, operative duration, blood loss, and complication rates were evaluated. Preoperative and postoperative residual tumor volumes were measured using OsiriX software based on MRI. A 15 ml cut value divided the subjects into large versus small meningioma groups.
RESULTS: The average resection rate for meningiomas was 95.2% compared with 83.9% for craniopharyngiomas and 53.2% for pituitary adenomas. The major complication rate (primarily blindness and hemiplegia) was 4.48% in all tumors. No operative-related deaths occurred. There were no surgical revisions to traditional large craniotomies. No significant differences in age, gender, postoperative volumes, resection rates, or recurrence rates were noted between small and large meningioma groups. However, longer operative times and hospital stays, and greater blood loss occurred in the large meningioma group.
CONCLUSIONS: Transciliary keyhole craniotomy is a safe and effective approach for anterior skull base tumors, especially meningiomas. Excellent resection results were achieved even in cases of large meningiomas. Although longer operative times, hospital stays, and greater blood loss occurred in larger compared with smaller meningioma cases, recurrence rates were similar.

PMID: 29325954 [PubMed - as supplied by publisher]

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