Shkarubo AN, Chernov IV, Veselkov AA, Andreev DN, Yakupova ZF, Kalinin PP. [Endoscopic transnasal resection of clival meningiomas].
Zh Vopr Neirokhir Im N N Burdenko 2024;
88:105-111. [PMID:
38549417 DOI:
10.17116/neiro202488021105]
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Abstract
BACKGROUND
Surgical treatment of ventral and ventrolateral meningiomas of posterior cranial fossa is difficult in modern neurosurgery. This is due to peculiarities of approach to these areas and concentration of critical structures (cranial nerves and great vessels). Currently, endoscopic transnasal approach to these meningiomas allows partial, and in some cases, total resection. However, this technique is not widespread.
OBJECTIVE
To analyze the world literature data on postoperative outcomes in patients with clival and petroclival meningiomas after endoscopic transnasal resection.
MATERIAL AND METHODS
We analyzed 22 articles representing treatment of 61 patients with clival and petroclival meningiomas.
RESULTS
Total or near-total resection was achieved in 22.9% of cases, subtotal resection - 40.9%, partial resection - 26.2% (data were not provided in other cases). Even partial and subtotal resection leads to significant regression of symptoms.
CONCLUSION
Endoscopic transnasal surgery is a full-fledged alternative to transcranial approaches in surgical treatment of clival meningiomas. It is also an additional option for patients with petroclival meningiomas after ineffective transcranial approaches. Transnasal tumor shrinkage and devascularization lead to brainstem decompression, regression of hydrocephalus and baseline clinical symptoms.
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