title: Evolution and future of skull base surgery: the paradigm of skull base meningiomas.
abstract: BACKGROUND
  Skull base meningiomas represent the paradigm for the evolution of skull base surgery within the past 50 years into a distinct neurosurgical subspecialty.
  
  
  METHODS
  From 2005 to 2011, 117 patients with cranial base meningiomas underwent surgical resection. Extent of resection, histologic grade, complications, functional status, and recurrence-free and overall survival data are presented.
  
  
  RESULTS
  The summary rate of gross total resection was 53.0%. The surgical complication and mortality rates were 17.9% and 0.9%, respectively. Five-year recurrence-free survival was 88.0% for grade I meningiomas. A total of 90.3% of patients had a Karnofsky performance score ≥ 80 at last follow-up.
  
  
  CONCLUSIONS
  A large contemporary series of skull base meningiomas is presented. In addition, the evolution of surgical approaches to skull base meningiomas is reviewed, together with the current issues regarding radiation therapy, management of cavernous sinus tumor, oncologic management of atypical and malignant subtypes, molecular genetics, and future therapeutic options.
authors: Department of Neurological Surgery, University of Washington, Harborview Medical Center, Seattle, Washington, USA.
authors: Salvatore
authors: S
authors: Di Maio
authors: Dinesh
authors: D
authors: Ramanathan
authors: Rabindranath
authors: R
authors: Garcia-Lopez
authors: Michael Herbas
authors: MH
authors: Rocha
authors: Francisco Ponce
authors: FP
authors: Guerrero
authors: Manuel
authors: M
authors: Ferreira
authors: Laligam N
authors: LN
authors: Sekhar
mesh_terms: D000368:Aged; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D008579:Meningioma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000639:trends*; D019291:Skull Base / Q000473:pathology / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*