title: Endoscope-assisted microsurgical resection of skull base meningiomas.
abstract: This study aims to determine the value of endoscope assistance in the microsurgical resection of skull base meningiomas. Fourty-six patients harboring a skull base meningioma underwent an endoscope-assisted microsurgical resection. In 30 patients (65%), tumor parts which could not be visualized under the microscope were detected with the endoscope. In 26 patients (56%), these tumor remnants were removed under endoscopic view. Gross total resection was achieved in 35 patients (76%) and near-total resection in 11 (24%). There was no surgical mortality. The major complication was new cranial nerve deficit. The application of endoscopes was most useful in the small supraorbital craniotomies to look under the ipsilateral optic nerve and internal carotid artery as well as to visualize the diaphragm sellae and olfactory groove. In the retrosigmoid craniotomies, the endoscope was beneficial to inspect the internal auditory canal, to look into Meckel's cave, or to inspect areas hidden behind the jugular tubercle and tentorial edge. There was no obvious complication related to the application of the endoscope. Endoscope assistance is particularly of value when skull base meningiomas are to be removed via small craniotomies to inspect blind corners which cannot be visualized in a straight line with the microscope. In addition, there is a benefit of using endoscopes with various angles of view in standard craniotomies and skull base approaches to look around bony and dural corners or to look behind neurovascular structures, by which the amount of skull base drilling and retraction to expose the tumor can be reduced.
authors: Department of Neurosurgery, Ernst Moritz Arndt University, Sauerbruchstr, 17487, Greifswald, Germany. henry.schroeder@uni-greifswald.de
authors: Henry W S
authors: HW
authors: Schroeder
authors: Anne-Katrin
authors: AK
authors: Hickmann
authors: Jörg
authors: J
authors: Baldauf
references: Neurosurgery. 1999 Jan;44(1):106-10; discussion 110-2
references: 9894970
references: J Neurosurg. 1996 Jan;84(1):20-8
references: 8613831
references: Neurosurgery. 2007 May;60(5):844-52; discussion 844-52
references: 17460519
references: J Clin Neurosci. 1999 Jan;6(1):27-30
references: 10833567
references: Neurosurgery. 2005 Mar;56(3):546-59; discussion 546-59
references: 15730581
references: Neurosurgery. 2008 Jul;63(1):36-52; discussion 52-4
references: 18728567
references: J Neurosurg. 1994 Dec;81(6):860-8
references: 7965116
references: Neurosurgery. 2009 Jun;64(6):1090-9; discussion 1099-101
references: 19487888
references: Acta Neurochir (Wien). 2009 Mar;151(3):287-8; author reply 289-90
references: 19229470
references: Neurosurgery. 1994 Jun;34(6):1009-16; discussion 1016
references: 8084385
references: Neurosurgery. 2009 May;64(5 Suppl 2):269-84; discussion 284-6
references: 19287324
references: Neurosurgery. 1998 Feb;42(2):219-24; discussion 224-5
references: 9482171
references: Acta Neurochir Suppl. 1996;65:86-91
references: 8738504
references: Eur J Surg Oncol. 2007 Feb;33(1):109-13
references: 17110074
references: Neurosurgery. 1998 Dec;43(6):1330-6; discussion 1336-7
references: 9848846
references: Acta Neurochir (Wien). 2003 Aug;145(8):631-42; discussion 642
references: 14520541
references: Neurosurgery. 2007 Nov;61(5 Suppl 2):E239-40; discussion E240
references: 18091219
references: Neurosurg Rev. 2009 Jul;32(3):303-8; discussion 308
references: 19370368
references: Neurosurgery. 2006 Nov;59(5):1019-28; discussion 1028-9
references: 17143236
references: Neurosurgery. 1998 Feb;42(2):226-31; discussion 231-2
references: 9482172
references: Neurosurgery. 1995 Jun;36(6):1128-9; discussion 1129-30
references: 7643991
references: J Neurosurg. 2004 Aug;101(2):227-32
references: 15309912
references: J Neurosurg. 2005 Nov;103(5):920-2
references: 16304998
references: Neurosurgery. 2006 Apr;58(4):626-39, discussion 626-39
references: 16575326
references: Neurosurgery. 1996 Apr;38(4):737-40
references: 8692393
references: Laryngoscope. 2006 Oct;116(10):1882-6
references: 17003708
references: Neurosurg Focus. 2005 Aug 15;19(2):E7
references: 16122216
references: Acta Neurochir (Wien). 1996;138(4):402-10
references: 8738390
references: J Neurosurg. 2009 Nov;111(5):1078-90
references: 19374499
references: Neurosurgery. 2000 Jul;47(1):139-50; discussion 150-2
references: 10917357
references: Neurosurgery. 2008 Jun;62(6 Suppl 3):1182-91
references: 18695539
references: Neurosurgery. 1999 May;44(5):1095-100; discussion 1100-2
references: 10232543
references: Neurosurgery. 1999 Dec;45(6):1474-7
references: 10598717
references: Skull Base. 2002 Aug;12(3):119-24
references: 17167663
references: Neurosurgery. 2004 Apr;54(4):876-81; discussion 881-3
references: 15046653
references: Neurosurgery. 2010 May;66(5):883-92; discussion 892
references: 20414977
references: Neurosurgery. 2007 Jan;60(1):46-58; discussion 58-9
references: 17228252
references: Neurosurgery. 2005 Oct;57(4 Suppl):242-55; discussion 242-55
references: 16234671
references: Acta Neurochir Suppl. 1996;65:92-4
references: 8738505
references: Minim Invasive Neurosurg. 2005 Feb;48(1):39-43
references: 15747215
references: J Neurosurg. 2000 Feb;92(2):235-41
references: 10659009
references: Neurosurgery. 2007 Jun;60(6):982-91; discussion 991-2
references: 17538371