Bernat et al., from the Department of Neurosurgery Toronto Western Hospital, La Pitié-Salpêtrière hospital, Paris, France. King Faisal Specialist Hospital and Research Center, Riyadh, Ain Shams University, Cairo, Egypt, performed a retrospective analysis of patients submitted to endoscopic endonasal approach or transcranial approach for anterior skull base meningiomas (ASBM) resection from May 2006 to January 2016 Clinical, radiological and pathology data were retrieved for analysis. Tumor size, location, surgical technique, extent of resection and tumour grade were assessed. The two groups were compared to identify predictors and differences regarding tumor recurrence.
Fifty-two patients (17 Olfactory Groove meningioma & 35 Tuberculum sellae meningioma) were included; 26 (6 Olfactory Groove meningioma & 20 Tuberculum sellae meningioma) underwent endoscopic endonasal approach and 26 (13 Olfactory Groove meningioma & 13 Tuberculum sellae meningioma) transcranial approach, with a mean follow up of 41 months. GTR was achieved in 38 (73%) patients (18 (69%) in endoscopic endonasal approach and 20 (77%) in transcranial approach). Eight (15 %) patients presented with recurrence (5 (19 %) in endoscopic endonasal approach group; 3(11.5%) in transcranial approach group without statistical difference (p= 0.69). Among the recurrences, GTR had been achieved in 1 case of each group. In group endoscopic endonasal approach, one patient underwent transcranial approach for a recurrent tumor and another patient was referred for radiosurgery.
This study has shown an overall similar recurrence rate of Anterior skull base meningioma regardless the technique used. However analysis of larger series with longer follow-up is necessary to clearly define the indications and to fully validate the efficacy of endoscopic endonasal approach 1).