Cranial base reconstruction in patients with olfactory groove meningioma using endoscopic endonasal approaches
Keywords:
cerebrospinal fluid leak, leukocyte and platelet rich fibrin, meningioma, neuroendoscopy, skull base.Abstract
Introduction: Reconstruction of the anterior cranial base for meningiomas of the olfactory groove through endoscopic endonasal approaches represents a high challenge, given the large tumor dimensions and their more ventral disposition in the cranial base.Objective: To describe the effectiveness of a cranial base repair strategy in patients with olfactory groove meningiomas, through endoscopic endonasal approaches.
Method: A descriptive study was carried out on 11 patients from the Hermanos Ameijeiras Hospital who underwent surgery for meningiomas of the olfactory groove using the extended transcribiform endoscopic endonasal approach, in which a cranial base repair strategy was used that includes: Estimation of a safety index of the nasoseptal flap, method of space shortening of the nasoseptal flap, autologous elements, regenerative medicine and lumbar spinal drainage. For data analysis, absolute and relative frequencies were used as summary measures.
Results: The strategy was effective in 100% of patients. A patient with crusted, rhinitis and nasal synechiae is reported.
Conclusions: The present cranial base repair strategy for patients with olfactory groove meningioma, using endoscopic endonasal approaches, is effective, safe and reduces postoperative complications.
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References
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22. Vargas Gálvez C, López Arbolay O, Ortiz Machín M, Diego de la Campa J, Gómez Cardellá M, León Hernández I, et al. Fibrina rica en plaquetas y leucocitos en abordajes endonasales endoscópicos. Rev Cub Med Milit. 2024 [acceso: 24/02/2024]; 53(1): [aprox. 12 p.]. Disponible en: https://revmedmilitar.sld.cu/index.php/mil/article/view/14264
2. Baiano C, Somma T, Franca RA, Di Costanzo M, Scala MR, Cretella P, et al. Evolution in endoscopic endonasal approach for the management of hypothalamic-pituitary region metastasis: A single-institution experience. Front Oncol. 2022; 12:975738. DOI: 10.3389/fonc.2022.975738
3. Martínez-Pérez R, Requena LC, Carrau RL, Prevedello DM. Modern endoscopic skull base neurosurgery. J Neurooncol. 2021; 151(3):461-75. DOI: 10.1007/s11060-020-03610-9
4. Candy NG, Hinder D, Jukes AK, Wormald PJ, Psaltis AJ. Olfaction preservation in olfactory groove meningiomas: a systematic review. Neurosurg Rev. 2023; 46:186. DOI: 10.1007/s10143-023-02096-z
5. Wang EW, Zanation AM, Gardner PA, Schwartz TH, Eloy JA, Adappa ND, et al. ICAR: endoscopic skull-base surgery. Int Forum Allergy Rhinol. 2019; 9(S3):145-365. DOI: 10.1002/alr.22326
6. Fu TS, Yao CMKL, Ziai H, Monteiro E, Almeida JP, Zadeh G, et al. Cost-effectiveness of endoscopic endonasal vs transcranial approaches for olfactory groove meningioma. Head Neck. 2021; 43(1):79-88. DOI: 10.1002/hed.26462
7. Iranmehr A, Zeinalizadeh M, Namvar M, Fathi A, Azimi H, Tabari A, et al. Endoscopic endonasal management of skull base defects in pediatric patients. Int J Pediatr Otorhinolaryngol. 2021; 150:110902. DOI: 10.1016/j.ijporl.2021.110902
8. Heng L, Zhang S, Qu Y. Cross-reinforcing suturing and intranasal knotting for dural defect reconstruction during endoscopic endonasal skull base surgery. Acta Neurochir (Wien). 2020; 162(10):2409-12. DOI: 10.1007/s00701-020-04367-w
9. Williams IJM, Navaratnam AV, Wilson M, Ferguson MS. Endoscopic Endonasal Repair and Reconstruction of Traumatic Anterior Skull Base Defects. Case Rep Otolaryngol. 2023; 2023:6996215. DOI: 10.1155/2023/6996215
10. Vargas Gálvez CR, López Arbolay O, Ortiz Machín MM. Minimally invasive approach for skull base meningiomas. Neurocirugia (Astur : Engl Ed). 2024:2529-8496(24)00007-8. DOI: 10.1016/j.neucie.2023.11.002
11. Li LF, Pu JK, Chung JC, Lui WM, Leung GK. Repair of Anterior Skull Base Defect by Dual-Layer/Split-Frontal Pericranial Flap. World Neurosurg. 2019; 122:59-62. DOI: 10.1016/j.wneu.2018.10.112
12. Vargas Gálvez C, López Arbolay O, Ortiz Machín M. Barrera de reparación de la base craneal en los abordajes endonasales endoscópicos. Revista Cubana de Medicina Militar. 2023 [acceso: 24/02/2024]; 52(4):e023014321. Disponible en: https://revmedmilitar.sld.cu/index.php/mil/article/view/14321
13. Gardner PA, Kassam AB, Thomas A, Snyderman CH, Carrau RL, Mintz AH, Prevedello DM. Endoscopic endonasal resection of anterior cranial base meningiomas. Neurosurgery. 2008; 63(1):36-52. DOI: 10.1227/01.NEU.0000335069.30319.1E
14. Koutourousiou M, Fernandez-Miranda JC, Wang EW, Snyderman CH, Gardner PA. Endoscopic endonasal surgery for olfactory groove meningiomas: outcomes and limitations in 50 patients. Neurosurg Focus. 2014; 37(4):E8. DOI: 10.3171/2014.7.focus14330
15. de Almeida JR, Carvalho F, Vaz Guimaraes Filho F, Kiehl TR, Koutourousiou M, Su S, et al. Comparison of endoscopic endonasal and bifrontal craniotomy approaches for olfactory groove meningiomas: A matched pair analysis of outcomes and frontal lobe changes on MRI. J Clin Neurosci. 2015; 22(11):1733-41. DOI: 10.1016/j.jocn.2015.03.056
16. Shetty SR, Ruiz-Treviño AS, Omay SB, Almeida JP, Liang B, Chen YN, et al. Limitations of the endonasal endoscopic approach in treating olfactory groove meningiomas. A systematic review. Acta Neurochir (Wien). 2017; 159(10):1875-85. DOI: 10.1007/s00701-017-3303-0
17. Purohit A, Jha R, Khalafallah AM, Price C, Rowan NR, Mukherjee D. Endoscopic endonasal versus transcranial approach to resection of olfactory groove meningiomas: a systematic review. Neurosurg Rev. 2020; 43(6):1465-71. DOI: 10.1007/s10143-019-01193-2
18. Liu JK, Silva NA, Sevak IA, Eloy JA. Transbasal versus endoscopic endonasal versus combined approaches for olfactory groove meningiomas: importance of approach selection. Neurosurg Focus. 2018; 44(4):E8. DOI: 10.3171/2018.1.FOCUS17722
19. Banu MA, Mehta A, Ottenhausen M, Fraser JF, Patel KS, Szentirmai O, et al. Endoscope-assisted endonasal versus supraorbital keyhole resection of olfactory groove meningiomas: comparison and combination of 2 minimally invasive approaches. J Neurosurg. 2016; 124(3):605-20. DOI: 10.3171/2015.1.JNS141884
20. López Arbolay O, Ortiz Machín M, Marrero Aliño M, Santana Chil L. Meningiomas del surco olfatorio. Consideraciones del abordaje endonasal endoscópico extendido transcribiforme. Revchilneurocir. 2019 [acceso: 14/05/2023]; 42(1):31-7. Disponible en: https://revistachilenadeneurocirugia.com/index.php/revchilneurocirugia/article/view/90
21. Vargas Gálvez C, López Arbolay O, Ortiz Machín M. Radioanatomía nasosinusal aplicada en la reconstrucción de la base craneal en los abordajes endonasales endoscópicos. Anales de la Academia de Ciencias de Cuba . 2023 [acceso: 24/02/2024]; 13 (4): [aprox. 8 p]. Disponible en: https://revistaccuba.sld.cu/index.php/revacc/article/view/1413/1850
22. Vargas Gálvez C, López Arbolay O, Ortiz Machín M, Diego de la Campa J, Gómez Cardellá M, León Hernández I, et al. Fibrina rica en plaquetas y leucocitos en abordajes endonasales endoscópicos. Rev Cub Med Milit. 2024 [acceso: 24/02/2024]; 53(1): [aprox. 12 p.]. Disponible en: https://revmedmilitar.sld.cu/index.php/mil/article/view/14264
Published
2024-05-03
How to Cite
1.
Vargas Gálvez CR, López Arbolay O, Ortiz Machín MM. Cranial base reconstruction in patients with olfactory groove meningioma using endoscopic endonasal approaches. Rev Cubana Med Milit [Internet]. 2024 May 3 [cited 2025 Jan. 9];53(2):e024015863. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/15863
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