gms | German Medical Science

Objective: To evaluate the suitability of the frontolateral approach in the treatment of older patients with an anterior cranial base or perisellar meningioma.

Methods: We retrospectively analyzed the data of 65 patients operated in our neurosurgical department due to meningiomas of the anterior cranial base or perisellar region using a frontolateral approach between January 2006 and December 2012. We evaluated the patient charts, operating reports, ICU and anesthesiologic charts. To evaluate the influence of age on morbidity, mortality and time of hospitalization the patients were divided into two groups: group A patients <65 years, group B patients 65 years or older.

Results: At time of surgery 49 patients (75.4%) were younger than 65 years and the remaining 16 patients (24.6%) were 65 years or older. The mean age was 55.6 years (SD: 13.5 years). The mortality was in both groups 0%. 7 patients of group A (14.3%) and 1 patient of group B (6.3%) had postoperative complications. In group A 4 patients developed postoperative CSF fistula, 2 patients developed postoperative brain edema and 1 patient had a temporary paresis of the facial nerve. In group B one patient suffered from a postoperative temporary paresis of the facial nerve. The analysis showed that older patients were not more frequently affected by postoperative complications than younger patients. The average time of hospitalization was in group A 8.2 nights (SD: 3.3 nights) and in group B 9.8 nights (SD: 3.4 nights). The difference was significant (p=0.043).

Conclusion: Generally the frontolateral approach has a low risk of complication and mortality. There was no significant increase of morbidity and mortality in the group of older patients. However the time of hospitalization was significantly prolonged in older patients. Nevertheless, the frontolateral approach showed to be a safe route to address meningiomas of the anterior cranial base and perisellar region in young as well as in older patients.