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57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

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Endoscope-assisted microsurgical removal of skull base tumors

Endoskopisch-assistierte mikrochirurgische Schädelbasischirurgie

Meeting Abstract

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  • corresponding author H.W.S. Schroeder - Klinik für Neurochirurgie, Ernst-Moritz-Arndt Universität, Greifswald
  • J. Baldauf - Klinik für Neurochirurgie, Ernst-Moritz-Arndt Universität, Greifswald
  • J. Oertel - Klinik für Neurochirurgie, Nordstadt Krankenhaus, Hannover
  • M.R. Gaab - Klinik für Neurochirurgie, Nordstadt Krankenhaus, Hannover

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocSO.01.01

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc157.shtml

Published: May 8, 2006

© 2006 Schroeder et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: In general, microsurgical removal is the therapy of choice for the treatment of benign skullbase tumors. The beneficial effect of endoscopes for the removal of such tumors is illustrated.

Methods: Seventy-one patients with a skull base tumor were treated using an endoscope-assisted microsurgical technique. The tumors included 32 meningeomas, 18 vestibular schwannomas, 6 epidermoids, 8 craniopharygeomas, and 7 miscellaneous lesions. Most of the tumor mass was removed using the operating microscope In 36 patients, tumor parts which were not visible in a straight line were removed under endoscopic control. In the remaining patients, the endoscope was used during the surgery for inspection only.

Results: All tumors except for four petroclival meningeomas with infiltration of the cavernous sinus (3) or brainstem (1) were completely removed. There was no mortality. Permanent neurological deficits included 4 facial palsies, 6 cases of deafness, 1 anosmia, and 1 hypoglossal palsy. In 14 patients, tumor parts were identified which were not visible under the microscope. Postoperative MR imaging revealed complete tumor resection in 67 cases (mean follow-up 14 months).

Conclusions: The endoscope-assisted microsurgical technique enables a safe tumor removal even when tumor parts are not visible in a straight line. Neurovascular retraction and skull base drilling can be reduced. Tumor extension into adjacent compartments, e. g. Meckel’s cave, can be removed via the same approach without enlarging the craniotomy.