Comparison of Three Surgical Approaches for Frontobasal Meningiomas: Purely Endoscopic Endonasal, Purely Microscopic Bifrontal Transcranial, and Combined Endoscopic and Microscopic Supraorbital Transciliary Approaches

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dc.authoridBaykara, Yigit/0000-0002-0483-5078
dc.authoridMeco, Cem/0000-0001-8372-8045
dc.contributor.authorKahilogullari, Gokmen
dc.contributor.authorBaykara, Yigit
dc.contributor.authorEroglu, Umit
dc.contributor.authorGuler, Tugba Morali
dc.contributor.authorBeton, Suha
dc.contributor.authorComert, Ayhan
dc.contributor.authorMeco, Cem
dc.date.accessioned2024-09-29T16:03:12Z
dc.date.available2024-09-29T16:03:12Z
dc.date.issued2021
dc.departmentKarabük Üniversitesien_US
dc.description.abstractSurgical removal of frontobasal meningiomas (FBMs) can be achieved using different techniques, including endoscopic, transcranial, and combined approaches. The advantages and disadvantages of the outcomes of these approaches should be compared to provide the most convenient surgical treatment to the patient. This study aimed to compare 3 surgical approaches for FBMsin terms of outcomes and determine the superiority of each on the basis of anatomical, surgical, and clinical efficacy. Systematic review was performed to identify studies comparing techniques for the surgical removal of FBMs. Each group included 13 patients; 39 patients with FBMshad undergone surgery. These groups were endoscopic endonasal approach (EEA), microscopic bifrontal transcranial approach (MTA), and endoscopic plus microscopic combined supraorbital transciliary approach (STA) groups. Data on the demographics of patient population, pre- and post-operative neurological examination, tumor properties, imaging studies, and surgical complications were extracted. The mean age at the time of surgery for the patient population was 53.2 years. Among the groups, no statistically significant differences were observed with regard to sex (P = 0.582). The mean follow-up time was 56.7 months. A statistically significant difference was observed in the mean tumor volume among the groups; the MTA group showed the highest mean tumor volume. However, no significant difference was found in the mean tumor volume between EEA and STA groups. Regarding operation duration, the STA group had the shortest operation time (mean = 281.5 minutes), whereas the average surgical duration in MTA group was the longest (mean = 443.8 minutes). The average bleeding volume was highest in the MTA group (mean = 746.2 ml) and lowest in the EEA group (mean = 320.8 ml). Tumor removal was incomplete in three patients (two in the EEA group and one in the MTA group). Recurrence was detected in two cases. One patient with recurrence was operated using the endoscopic surgical approach, whereas the other patient underwent the microscopic bifrontal approach. Post-operative hyposmia/anosmia or decreased olfactory function was the most common complication observed in 5 patients, 2 patients each in the EEA and MTA groups and one in the STA group. The second most common complication was wound infection in one patient in the MTA group and two patients in the STA group (7.7%). Both cerebrospinal fluid (CSF) leakage and meningitis were present in two patients (5.1%), one patient each from the EEA and STA groups. Pre-operative visual disturbances were reported in 13 patients (33.3%), all of which resolved post-operatively No statistical differences were found among the groups. Mortality occurred in a patient in the MTA group (2.6%) caused by cardiac arrest on post-operative day 1. This is the first study comparing the surgical outcomes of three surgical approaches for FBMs. Although recent literature suggests that both endoscopic and transcranial approaches have their own advantages and disadvantages, the authors showed that none of the surgical approaches have obvious superiority over the others with regard to outcomes. Thus, the selection of the ideal surgical approach should be based on surgical experience and tumor characteristics.en_US
dc.identifier.doi10.1097/SCS.0000000000006970
dc.identifier.endpage850en_US
dc.identifier.issn1049-2275
dc.identifier.issn1536-3732
dc.identifier.issue3en_US
dc.identifier.pmid32890143en_US
dc.identifier.scopus2-s2.0-85121958202en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage844en_US
dc.identifier.urihttps://doi.org/10.1097/SCS.0000000000006970
dc.identifier.urihttps://hdl.handle.net/20.500.14619/5951
dc.identifier.volume32en_US
dc.identifier.wosWOS:000662282900052en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.ispartofJournal of Craniofacial Surgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAnatomical relationshipen_US
dc.subjectanterior fossaen_US
dc.subjectapproachesen_US
dc.subjectendoscopic surgeryen_US
dc.subjectfrontobasalen_US
dc.subjectmeningiomaen_US
dc.subjectmicroscopyen_US
dc.titleComparison of Three Surgical Approaches for Frontobasal Meningiomas: Purely Endoscopic Endonasal, Purely Microscopic Bifrontal Transcranial, and Combined Endoscopic and Microscopic Supraorbital Transciliary Approachesen_US
dc.typeArticleen_US

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