Introduction: Many approaches to the anterior skull base have been reported. Frequently used are the pterional, the unilateral or bilateral frontobasal, the supraorbital and the frontolateral approach. Recently, endoscopic transnasal approaches have become more popular. The benefits of each approach has to be weighted against its complications and limitations. The aim of this study was to investigate if the unilateral anterior interhemispheric approach could be a safe and effective alternative approach to meningiomas of the anterior skull base.
Methods: We screened the operative records of all patients with anterior skull base meningiomas undergoing transcranial surgery. We have used it in 27 patients. There were a total of 27 cases of which 10 were planum sphenoidale, 8 were tuberculum sellae, 5 were olfactory groove, 3 were anterior clinoidal, 1 was a diaphragma sellae meningioma. Patient records were evaluated concerning accessibility of the lesion, complete tumor removal, and approach related complications.
Results: Complete tumor removal, was achieved in all patients. Frontal sinus was not violated in all cases. There was no neurological deficit due to the surgical approach. The complication rate was 7.4% ( superficial wound infection (n?=?1; 3.7%),and asymptomatic minor bleed into the surgical cavity in 1 case.
Conclusions: The unilateral anterior interhemispheric approach is an effective and a safe approach to meningiomas of the midline anterior skull base. This approach should be part of the armamentarium of skull base surgeons.
Patient Care: they should be able to choose the best approach for anterior skull base meningiomas
Learning Objectives: By the conclusion of this session, partecipants should be able to choose the best approach for anterior skull base meningiomas