Endoscopic Endonasal Transclival Approach to Tumors of the Clivus and Anterior Region of the Posterior Cranial Fossa (Results of Surgical Treatment of 136 Patients).

Autor: Shkarubo AN; Department of Neurooncology, Federal State Autonomous Institution N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russia., Koval KV; Department of Neurooncology, Federal State Autonomous Institution N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russia., Chernov IV; Department of Neurooncology, Federal State Autonomous Institution N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russia. Electronic address: ilch@list.ru., Andreev DN; Department of Neurooncology, Federal State Autonomous Institution N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russia., Panteleyev AA; Department of Spine Pathology, N.N. Priorov Central Institute of Traumatology and Orthopedics, Moscow, Russia.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2019 Jan; Vol. 121, pp. e246-e261. Date of Electronic Publication: 2018 Sep 24.
DOI: 10.1016/j.wneu.2018.09.090
Abstrakt: Introduction: With the introduction into the neurosurgical practice of minimally invasive methods using endoscopic techniques, it became possible to effectively remove hard-to-reach tumors, including central tumors of the anterior region of the posterior cranial fossa.
Objective: To analyze the results of surgical treatment of patients with various centrally located tumors of the base of the skull that extend into the anterior region of the posterior cranial fossa using the endoscopic endonasal transclival approach.
Methods: The personal surgical experience of the first author is 136 patients with various tumors (e.g., chordomas, meningiomas, pituitary adenomas, and fibrous dysplasia).
Results: Radicality of tumor removal was total 61.03%; subtotal 25%; partial 13.23%; and insufficient removal 0.74%. Postoperative cerebrospinal fluid leaks occurred in 9 cases (6.62%) and meningitis in 13 cases (9.56%). In 2 cases, surgical treatment had a lethal outcome (1.47%).
Conclusions: The endoscopic endonasal transclival approach can be used to obtain access to centrally located skull base tumors. This approach allows for a radical and low-risk removal of various skull base tumors of central localization that, until recently, were considered to be almost inoperable.
(Copyright © 2018 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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