Management of Intracranial Meningiomas Using Keyhole Techniques.
| Autor: | Burks JD; Department of Neurosurgery, University of Oklahoma Health Sciences Center., Conner AK; Department of Neurosurgery, University of Oklahoma Health Sciences Center., Bonney PA; Department of Neurosurgery, University of Oklahoma Health Sciences Center., Archer JB; Department of Neurosurgery, Indiana University School of Medicine., Christensen B; Department of Anesthesiology, University of Oklahoma Health Sciences Center., Smith J; Department of Anesthesiology, University of Oklahoma Health Sciences Center., Safavi-Abbasi S; Department of Neurosurgery, University of Oklahoma Health Sciences Center., Sughrue M; Department of Neurosurgery, University of Oklahoma Health Sciences Center. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2016 Apr 27; Vol. 8 (4), pp. e588. Date of Electronic Publication: 2016 Apr 27. |
| DOI: | 10.7759/cureus.588 |
| Abstrakt: | Background: Keyhole craniotomies are increasingly being used for lesions of the skull base. Here we review our recent experience with these approaches for resection of intracranial meningiomas. Methods: Clinical and operative data were gathered on all patients treated with keyhole approaches by the senior author from January 2012 to June 2013. Thirty-one meningiomas were resected in 27 patients, including 9 supratentorial, 5 anterior fossa, 7 middle fossa, 6 posterior fossa, and 4 complex skull base tumors. Twenty-nine tumors were WHO Grade I, and 2 were Grade II. Results: The mean operative time was 8 hours, 22 minutes (range, 2:55-16:14) for skull-base tumors, and 4 hours, 27 minutes (range, 1:45-7:13) for supratentorial tumors. Simpson Resection grades were as follows: Grade I = 8, II = 8, III = 1, IV = 15, V = 0. The median postoperative hospital stay was 4 days (range, 1-20 days). In the 9 patients presenting with some degree of visual loss, 7 saw improvement or complete resolution. In the 6 patients presenting with cranial nerve palsies, 4 experienced improvement or resolution of the deficit postoperatively. Four patients experienced new neurologic deficits, all of which were improved or resolved at the time of the last follow-up. Technical aspects and surgical nuances of these approaches for management of intracranial meningiomas are discussed. Conclusions: With careful preoperative evaluation, keyhole approaches can be utilized singly or in combination to manage meningiomas in a wide variety of locations with satisfactory results. |
| Databáze: | MEDLINE |
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