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Urbančič J, Bošnjak R, Vozel D. Transglabellar Butterfly Incision for Anterior Cranial Vault Access: Case Report. Curr Oncol 2024; 31:5233-5241. [PMID: 39330015 PMCID: PMC11430991 DOI: 10.3390/curroncol31090387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/30/2024] [Accepted: 09/04/2024] [Indexed: 09/28/2024] Open
Abstract
(1) Background: The transglabellar approach, a type of transfacial technique, typically involves glabellar resection and opening the frontal sinus via a bicoronal incision, providing access to the anterior cranial vault. To prevent complications, the frontal sinus is typically obliterated. However, the success of transnasal endoscopic techniques has prompted a re-evaluation of these traditional methods. (2) Methods: This paper provides a brief literature review and discusses the removal of an elongated glioma of the left gyrus rectus (4.4 × 1.9 × 2.2 cm) in a 63-year-old male using a transglabellar subfrontal approach via a butterfly incision, with frontal sinus preservation. (3) Results: An uneventful gross-total resection of a WHO grade II oligodendroglioma was achieved. There is a paucity of literature describing a transglabellar subfrontal approach via a butterfly incision with frontal sinus preservation. (4) Conclusions: The described approach could be utilized in selected cases such as small intra-axial lesions oriented longitudinally along the inferomedial frontal lobe from the posterior wall of the frontal sinus to the anterior communicating artery complex in patients with pre-existing glabellar rhytids. Since this is merely a case presentation, we cannot conclude that this represents established clinical practice. The outcomes of this approach should be investigated in the future.
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Affiliation(s)
- Jure Urbančič
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Roman Bošnjak
- Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
- Department of Neurosurgery, University Medical Centre Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia
| | - Domen Vozel
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
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2
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Jannelli G, Calvanese F, Jouanneau E, Jacquesson T. Frontal trans-sinusal approach: how I do it. Acta Neurochir (Wien) 2023; 165:2963-2968. [PMID: 37672096 DOI: 10.1007/s00701-023-05785-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/26/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Anterior skull base lesions could be reached by different approaches (subfrontal, pterional, interhemispheric, etc.). In selected cases, the frontal trans-sinusal approach is an effective alternative to conventional techniques. METHODS We present our technique to perform a frontal trans-sinusal approach in a patient affected by a large olfactory groove meningioma. DISCUSSION-CONCLUSION The frontal trans-sinusal approach allows to approach safely lesions of the median anterior cranial fossa. This approach provides lower brain retraction, easier access to olfactory grooves, and earlier tumor devascularization. However, it remains limited to patients with large-sized frontal sinuses and entails some postoperative risks such as mucocele or CSF leak.
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Affiliation(s)
- Gianpaolo Jannelli
- Department of Neurosurgery, Neurocenter of Southern Switzerland, Ospedale Regionale Di Lugano, Lugano, Switzerland
- Skull Base and Pituitary Neurosurgical Department, Hôpital Neurologique Pierre Wertheimer, Claude Bernard University, Lyon, France
| | - Francesco Calvanese
- Skull Base and Pituitary Neurosurgical Department, Hôpital Neurologique Pierre Wertheimer, Claude Bernard University, Lyon, France.
- Department of Neurosurgery, Helsinki University Central Hospital, Haartmaninkatu 4, 00290, Helsinki, Finland.
| | - Emmanuel Jouanneau
- Skull Base and Pituitary Neurosurgical Department, Hôpital Neurologique Pierre Wertheimer, Claude Bernard University, Lyon, France
- Lyon 1 University, Lyon, France
| | - Timothée Jacquesson
- Skull Base and Pituitary Neurosurgical Department, Hôpital Neurologique Pierre Wertheimer, Claude Bernard University, Lyon, France
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Candy NG, Hinder D, Jukes AK, Wormald PJ, Psaltis AJ. Olfaction preservation in olfactory groove meningiomas: a systematic review. Neurosurg Rev 2023; 46:186. [PMID: 37500988 PMCID: PMC10374754 DOI: 10.1007/s10143-023-02096-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/08/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023]
Abstract
Olfactory groove meningiomas (OGM) are a skull base neoplasm that represents between 8 and 13% of all intracranial meningiomas. Approach selection focuses on achieving frontal lobe decompression, gross total resection and vision preservation. Recently, there has been a focus on olfaction and considering its preservation as a quality-of-life outcome measure. An electronic search of the databases Medline, Scopus, Embase, Web of Science and Cochrane library databases was performed and data extracted according 2020 Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) statement. Six articles were selected for inclusion mainly based due to reporting quantitative outcomes for olfaction assessed by a smell identification test (e.g. sniffin' sticks). Objective olfaction preservation can be achieved with a variety of surgical approaches. More research which includes objective assessment of olfactory function and ideally as well QoL outcome measures is needed to further optimize the treatment pathways in OGM patients.
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Affiliation(s)
- Nicholas G Candy
- Department of Surgery Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Research, Woodville South, Adelaide, Australia.
| | - Dominik Hinder
- Department of Surgery Otorhinolaryngology Head and Neck Surgery, Queen Elizabeth Hospital, Adelaide, SA, Australia
| | - Alistair K Jukes
- Department of Neurosurgery, Royal Adelaide Hospital, Adelaide, Australia
| | - Peter-John Wormald
- Department of Surgery Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Research, Woodville South, Adelaide, Australia
| | - Alkis J Psaltis
- Department of Surgery Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Research, Woodville South, Adelaide, Australia
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Supsupin EP, Gonzales NS, Debnam JM. Anatomy and Pathology of the Skull Base: Malignant and Nonmalignant Lesions. Oral Maxillofac Surg Clin North Am 2023:S1042-3699(23)00025-0. [PMID: 37142448 DOI: 10.1016/j.coms.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The skull base (SB) is the osseous foundation of the cranial vault. It contains many openings that allow communication between the extracranial and intracranial structures. This communication is crucial in normal physiologic processes yet may also arrow spread of disease. This article provides a comprehensive review of SB anatomy including important landmarks and anatomic variants relevant to SB surgery. We also illustrate the diverse pathologies affecting the SB.
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Affiliation(s)
- Emilio P Supsupin
- Radiology/Neuroradiology, Radiology Residency Program, University of Florida College of Medicine, 655 West 8th. Street, Jacksonville, FL 32209, USA.
| | - Noelani S Gonzales
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL 33314, USA
| | - James Matthew Debnam
- Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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5
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Roa Montes de Oca JC, Gonçalves Estella JM, Nieto-Librero AB, Galindo-Villardón P, Roa Ramírez CJ, Gonçalves Sánchez J, Berhouma M, Cornelius JF, Daniel RT, Zazpe I, Froelich S, Jouanneau E, Mazzatenta D, Messerer M, Meling T, Paraskevopoulos D, Roche PH, Schroeder HWS, Tatagiba M, Visocchi M, Voormolen E, Ekkehard K, Bruneau M. Olfactory Groove Meningiomas: Comprehensive assessment between the different microsurgical transcranial approaches and the Endoscopic Endonasal Approaches, systematic review and metanalysis on behalf of the EANS skull base section. BRAIN & SPINE 2022; 2:101661. [PMID: 36605386 PMCID: PMC9808463 DOI: 10.1016/j.bas.2022.101661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/23/2022] [Accepted: 10/15/2022] [Indexed: 11/06/2022]
Abstract
•OGM surgery is much more complex than a simple debate of "from above or from below" (transcranial vs endoscopic).•Lateral Sub-frontal and Superior Interhemispheric seem the most effective, superior and versatile approaches for OGM.•Minimally Invasive Transcranial approaches showed no inferiority in OGM sized <4 cm.•Endoscopic Endonasal Approaches showed inferior results in surgical and in functional outcomes for OGM.
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Affiliation(s)
- Juan Carlos Roa Montes de Oca
- Department of Neurosurgery, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
- Department of Surgery - Neurosurgery, Universidad de Salamanca. Facultad de Medicina, Salamanca, Spain
- Policlínica San Javier, Telemedicine Neurosurgery Consultant, Barquisimeto, Venezuela
- Centro de Enseñanza e Investigación del Ultrasonido en Medicina (CEIUM), Barquisimeto, Venezuela
| | - Jesús María Gonçalves Estella
- Department of Neurosurgery, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
- Department of Surgery - Neurosurgery, Universidad de Salamanca. Facultad de Medicina, Salamanca, Spain
| | | | - Purificación Galindo-Villardón
- Department of Statistics, Universidad de Salamanca, Salamanca, Spain
- Centro de Investigación Institucional (CII). Universidad Bernardo O’Higgins, Av. Viel 1497, Santiago, Chile
| | - Carlos Julio Roa Ramírez
- Department of Neuroradiology. Policlinica San Javier, Barquisimeto, Venezuela
- Centro de Enseñanza e Investigación del Ultrasonido en Medicina (CEIUM), Barquisimeto, Venezuela
- Centro Docente de Imágenes de Alta Tecnología (CEDIAT), Barquisimeto, Venezuela
| | | | - Moncef Berhouma
- Department of Neurosurgery, Hopital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France
| | | | - Roy Thomas Daniel
- Department of Neurosurgery, Department of Neuroscience, Centre Hospitalier Universitaire Vaudois, University Hospital Lausanne, Switzerland
| | - Idoya Zazpe
- Department of Neurosurgery, University Hospital of Navarre, Pamplona, Spain
| | - Sébastien Froelich
- Department of Neurosurgery, Lariboisière Hospital, Université Paris Diderot, Paris, France
| | - Emmanuel Jouanneau
- Department of Neurosurgery, Hôpital Neurologique Pierre Wertheimer, Lyon, France
| | - Diego Mazzatenta
- Department of Neurosurgery, Neurological Sciences Institut IRCCS, Bologna, Italy
| | - Mahmoud Messerer
- Department of Neurosurgery, Department of Neuroscience, Centre Hospitalier Universitaire Vaudois, University Hospital Lausanne, Switzerland
| | - Torstein Meling
- Department of Neurosurgery, University Hospital of Geneva, Geneva, Switzerland
| | - Dimitrios Paraskevopoulos
- Department of Neurosurgery, Barts Health NHS Trust, St. Bartolomew’s and the Royal London Hospital, Barts and the London School of Medicine and Dentistry, QMUL, London, UK
| | - Pierre-Hugues Roche
- Department of Neurosurgery, Aix-Marseille Université, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Marseille, France
| | | | - Marcos Tatagiba
- Department of Neurosurgery, University Hospital Tübingen, Tübingen, Germany
| | - Massimilliano Visocchi
- Department of Neurosurgery, Institute of Neurosurgery Catholic University of Rome, Italy
| | - Eduard Voormolen
- Department of Neurosurgery, University Medical Center Utrecht, Netherlands
| | - Kasper Ekkehard
- Department of Neurosurgery, Steward Medical Group, Brighton, USA
| | - Michaël Bruneau
- Department of Neurosurgery, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Midline Skull Base Meningiomas: Transcranial and Endonasal Perspectives. Cancers (Basel) 2022; 14:cancers14122878. [PMID: 35740543 PMCID: PMC9220797 DOI: 10.3390/cancers14122878] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/25/2022] [Accepted: 06/03/2022] [Indexed: 12/07/2022] Open
Abstract
Simple Summary Skull base meningiomas have always represented a challenge for neurosurgeons. Despite their histological nature, they may be associated with unfavorable outcomes due to their deep-seated location and the surrounding neurovascular structures. Over time, several corridors have been proposed, each one carrying its own pros and cons. During the last decades, the endoscopic endonasal route has been asserted among the classic routes for a growing number of midline and paramedian lesions. Therefore, the aim of our paper is to present a comprehensive review of the indications and techniques for the management of skull base meningiomas, emphasizing the ambivalent and complementary role of the low and high routes. Abstract Skull base meningiomas have always represented a challenge for neurosurgeons. Despite their histological nature, they may be associated with unfavorable outcomes due to their deep-seated location and the surrounding neurovascular structures. The state of the art of skull base meningiomas accounts for both transcranial, or high, and endonasal, or low, routes. A comprehensive review of the pertinent literature was performed to address the surgical strategies and outcomes of skull base meningioma patients treated through a transcranial approach, an endoscopic endonasal approach (EEA), or both. Three databases (PubMed, Ovid Medline, and Ovid Embase) have been searched. The review of the literature provided 328 papers reporting the surgical, oncological, and clinical results of different approaches for the treatment of skull base meningiomas. The most suitable surgical corridors for olfactory groove, tuberculum sellae, clival and petroclival and cavernous sinus meningiomas have been analyzed. The EEA was proven to be associated with a lower extent of resection rates and better clinical outcomes compared with transcranial corridors, offering the possibility of achieving the so-called maximal safe resection.
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