Choosing an anterior midline approach to skull base tumors

Gol'bin D.A.; Cherekaev V.A.; Kozlov A.V.; Parshunina A.M.

doi:https://doi.org/10.17116/neiro2017812103-112

Close metadata

Recommended articles:

Basal encephalocele complicated by nasal liquorrhea in patients with craniosynostosis. Burdenko's Journal of Neurosurgery. 2025;(4):61-68

Constitutional features of structures of skull base in children aged 8—12 years old in normality and with recurrent subluxation of C1—C2 vertebrae. Russian Journal of Operative Surgery and Clinical Anatomy. 2025;(1):29-35

Abstract:

The purpose of this review is to analyze used anterior midline approaches to the skull base, identify their advantages and disadvantages, and, after reviewing the literature data, submit a developed algorithm for choosing an optimal approach to the approval of colleagues. We provide brief information on approach techniques, indications and contraindications, and advantages and disadvantages as well as analyze international experience of using the discussed approaches. On the basis of literature data, we have developed a prototype algorithm for choosing an optimal approach to medial tumors of the anterior skull base. The situation of choosing an optimal approach reveals the absence of a clear understanding of the boundaries between capabilities and limitations of approaches. To solve this problem, an original prospective study is required.

Keywords:

skull base

anterior cranial fossa

craniofacial tumors

subfrontal approach

transbasal approach

frontal sinus approach

subcranial approach

endoscopic endonasal approach

anterior craniofacial resection

Authors:

Gol'bin D.A.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Cherekaev V.A.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Kozlov A.V.

Kraevaia klinicheskaia bol'nitsa, Barnaul

Parshunina A.M.

Burdenko Neurosurgical Institute, Moscow, Russia

Close metadata

References:

Lang DA, Neil-Dwyer G, Garfield J. Outcome after complex neurosurgery: the caregiver’s burden is forgotten. J Neurosurg. 1999;91(3):359-363. doi:10.3171/jns.1999.91.3.0359
Di Ieva A, Lee JM, Cusimano MD, et al. Handbook of Skull Base Surgery. Stuttgart: Georg Thieme Verlag. 2016.
Pieper DR, LaRouere M, Jackson IT. Operative management of skull base malignancies: choosing the appropriate approach. Neurosurg Focus. 2002;12(5):e6.
Cappabianca P, Iaconetta G, Califano L, et al. Cranial, Craniofacial and Skull Base Surgery. Milano: Springer Milan. 2010.
Wigand M, Iro H, Bozzato A. Transcranial combined neurorhinosurgical approach to the paranasal sinuses for anterior skull base malignancies. Skull Base. 2009;19(02):151-158. doi:10.1055/s-0028-1096200
Carrau RL, Kassam AB, Caicedo-Granadas EE, Bhatki AM, Prevedello DM, Chan JM. Anterior subfrontal approach — tumor removal. Available at: http://emedicine.medscape.com/article/844449-overview. Accessed July 6, 2016
Konovalov AN, (ed). Skull base tumor surgery. M.: Antidor. 2004. (In Russ.).
Effendi ST, Rao VY, Momin EN, Cruz-Navarro J, Duckworth EAM. The 1-piece transbasal approach: operative technique and anatomical study. J Neurosurg. 2014;121(6):1446-1452. doi:10.3171/2014.8.JNS132609
Cherekaev VA, Konovalov AN, Korniyenko VN, Byakishev AKh, Belov AI, Vinokurov AG, Gulyayeva OA. A diluted subfrontal approach to tumors in the base of brain. Zh Vopr Neirokhir im N N Burdenko. 2003;2:10-16. (In Russ.).
Rosen MR, Rabinowitz MR, Farrell CJ, Schaberg MR, Evans JJ. Septal transposition: a novel technique for preservation of the nasal septum during endoscopic endonasal resection of olfactory groove meningiomas. Neurosurg Focus. 2014;37:E6. doi:10.3171/2014.7.FOCUS14308
Hallacq P, Moreau JJ, Fischer G, Béziat JL. Trans-sinusal frontal approach for olfactory groove meningiomas. Skull Base. 2001;11(1):35-46. doi:10.1055/s-2001-12786
Cherekaev VA, Korniyenko VN, Bekyashev AKh, Belov AI, Vinokurov AG, Pronin IN. Access to the anterior cranial fossa through the frontal sinus. Zh Vopr Neirokhir im N N Burdenko. 2002;2:25-28. (In Russ.).
Ciechomski J, Aufgang R, Villanueva L, Demarchi V. Subcranial approach in pediatric craniofacial surgery. Craniomaxillofac Trauma Reconstr. 2010;3(4):231-236. doi:10.1055/s-0030-1268521
Raveh J, Turk JB, Lädrach K, Seiler R, Godoy N, Chen J, Paladino J, Virag M, Leibinger K. Extended anterior subcranial approach for skull base tumors: long-term results. J Neurosurg. 1995;82(6):1002-1010. doi:10.3171/jns.1995.82.6.1002
Gil Z, Fliss DM. (eds.). Tumours of the Skull Base and Paranasal Sinuses. New Delhi: Springer India. 2012.
Abu-Ghanem S, Fliss DM. Surgical approaches to resection of anterior skull base and paranasal sinuses tumors. Balkan Med J. 2013;30(2):136-141. doi:10.5152/balkanmedj.2013.9112
Pepper J-P, Hecht SL, Gebarski SS, Lin EM, Sullivan SE, Marentette LJ. Olfactory groove meningioma: discussion of clinical presentation and surgical outcomes following excision via the subcranial approach. Laryngoscope. 2011;121(11):2282-2289. doi:10.1002/lary.22174
Pepper J-P, Ward P, Lin E, Sullivan S, Hecht S, Marentette L. Perioperative outcomes in patients undergoing the transglabellar/subcranial approach to the anterior skull base. Skull Base. 2011;21:215-222. doi:10.1055/s-0031-1277261
Har-El G. Anterior craniofacial resection without facial skin incisions — a review. Otolaryngol Head Neck Surg. 2004;130(6):780-787. doi:10.1016/j.otohns.2004.01.015
Kleiber JC, Roemer S, Duntze J, Eap C, Theret E, Rousseaux P, Litre F. Transglabellar approach for resection of anterior midline skull base meningiomas: technical note. Acta Neurochir (Wien). 2014;156(12):2283-2287. doi:10.1007/s00701-014-2223-5
Jho H, Ko Y. Glabellar approach: simplified midline anterior skull base approach. Minim Invas Neurosurg. 1997;40:62-67.
Nabili V, Kelly DF, Fatemi N, St John M, Calcaterra TC, Abemayor E. Transnasal, transfacial, anterior skull base resection of olfactory neuroblastoma. Am J Otolaryngol. 2011;32(4):279-285. doi:10.1016/j.amjoto.2010.05.003
Lund VJ. Malignant sinus tumors. In: Kennedy D, Hwang P, et al. Rhinology. Diseases of the Nose, Sinuses, and Skull Base. New York: Thieme medical publishers Inc. 2012;409-424.
Schwartz TH, Fraser JF, Brown S, Tabaee A, Kacker A, Anand VK. Endoscopic cranial base surgery: classification of operative approaches. Neurosurgery. 2008;62(5):991-1002. doi:10.1227/01.NEU.0000313231.81129.66
Wagenmann M, Schipper J. The transnasal approach to the skull base. From sinus surgery to skull base surgery. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2011;10.Doc08. doi:10.3205/cto000081
Kassam AB, Prevedello DM, Gardner PA, Fernandez-Miranda JC, Carrau RL, Snyderman CH. Endoscopic endonasal approach for anterior skull base meningiomas. In: Stamm A, et al. Transnasal Endoscopic Skull Base and Brain Surgery. Tips and Pearls. New York: Thieme medical publishers Inc. 2011;167-174.
Dave SP, Bared A, Casiano RR. Surgical outcomes and safety of transnasal endoscopic resection for anterior skull tumors. Otolaryngol Head Neck Surg. 2007;136(6):920-927. doi:10.1016/j.otohns.2007.01.012
Couldwell WT. Editorial: endoscopic endonasal approach to anterior skull base meningiomas. Neurosurg Focus. 2011;30(5):E4. doi:10.3171/2011.3.FOCUS1174
Eloy JA, Liu JK, Choudhry OJ, Anstead AS, Tessema B, Folbe AJ, Casiano RR. Modified subtotal Lothrop procedure for extended frontal sinus and anterior skull base access: a cadaveric feasibility study with clinical correlates. J Neurol Surgery Part B Skull Base. 2013;74(3):130-135. doi:10.1055/s-0033-1338264
Brunworth J, Padhye V, Bassiouni A, Psaltis A, Floreani S, Robinson S, Santoreneos S, Vrodos N, Parker A, Wickremesekera A, Wormald PJ. Update on endoscopic endonasal resection of skull base meningiomas. Int Forum Allergy Rhinol. 2015;5(4):344-352. doi:10.1002/alr.21457
Lehmberg J. Endoscopic transnasal surgery for pure intradural lesions — balance between advantages and disadvantages. Acta Neurochir (Wien). 2011;153:10-11. doi:10.1007/s00701-010-0789-0
Schwartz TH. Should endoscopic endonasal surgery be used in the treatment of olfactory groove meningiomas? Neurosurg Focus. 2014;37(4):E9. doi:10.3171/2014.7.FOCUS14457.2
Schroeder HWS. Indications and limitations of the endoscopic endonasal approach for anterior cranial base meningiomas. World Neurosurg. 2014;82(6):S81-S85. doi:10.1016/j.wneu.2014.07.030
Oostra A, van Furth W, Georgalas C. Extended endoscopic endonasal skull base surgery: from the sella to the anterior and posterior cranial fossa. ANZ J Surg. 2012;82(3):122-130. doi:10.1111/j.1445-2197.2011.05971.x
Castelnuovo P, Giovanetti F, Bignami M, Ungari C, Ianetti G. Open surgery versus endoscopic surgery in benign neoplasm involving the frontal sinus. J Craniofac Surg. 2009;20(1):180-183.
Frank G, Pasquini E. The transnasal versus the transcranial approach to the anterior skull base. World Neurosurg. 2013;80(6):782-783. doi:10.1016/j.wneu.2013.02.016
Prosser J, Vender J, Alleyne C, Solares C. Expanded endoscopic endonasal approaches to skull base meningiomas. J Neurol Surg Part B Skull Base. 2012;73(03):147-156. doi:10.1055/s-0032-1301391
Eloy JA, Tessema B, Casiano RR. Endoscopic approaches to the anterior cranial fossa. In: Kennedy D, Hwang P, et al. Rhinology. Diseases of the Nose, Sinuses, and Skull Base. New York: Thieme medical publishers Inc. 2012;605-614.
Mai JC,. Sekhar LN. Modern management of anterior skull base tumors. World Neurosurg. 2012;78(1-2):60-61. doi:10.1016/j.wneu.2012.01.009
Nicolai P, Yakirevich A, Bolzoni Villaret A, Battaglia P, Locatelli D, Castelnuovo P. Combined cranioendoscopic approach. In: Stamm A, et al. Transnasal Endoscopic Skull Base and Brain Surgery. Tips and Pearls. New York: Thieme medical publishers Inc. 2011;350-354.
Castelnuovo P, Belli E, Bignami M, Battaglia P. Endoscopic nasal and anterior craniotomy resection for malignant nasoethmoid tumors involving the anterior skull base. Skull Base. 2006;16(1):25-29.
Nicolai P, Castelnuovo P, Bolzoni Villaret A. Endoscopic resection of sinonasal malignancies. Curr Oncol Rep. 2011;13(2):138-144. doi:10.1007/s11912-011-0151-6
Castelnuovo P, Dallan I, Battaglia P, Bignami M. Endoscopic endonasal skull base surgery: past, present and future. Eur Arch Otorhinolaryngol. 2010;267(5):649-663. doi:10.1007/s00405-009-1196-0
Castelnuovo P, Bignami M, Battaglia P, Bolzoni Villaret A, Nicolai P. Endonasal surgery of malignancies of the sinus and skull base. In: Stamm A, et al. Transnasal Endoscopic Skull Base and Brain Surgery. Tips and Pearls. New York: Thieme medical publishers Inc. 2011;339-342.
Bolzoni Villaret A, Yakirevitch A, Bizzoni A, et al. Endoscopic transnasal craniectomy in the management of selected sinonasal malignancies. Am J Rhinol Allergy. 2010;24(1):60-65. doi:10.2500/ajra.2010.24.3397
de Divitiis E, Laws ER. The transnasal versus transcranial approach to lesions of the anterior skull base. World Neurosurg. 2013;80(6):728-731. doi:10.1016/j.wneu.2013.01.027
Cherekaev VA, Kadasheva AB, Golbin DA, Belov AI, Kozlov AV, Reshetov IV, Lasunin NV, Spirin DS. Tumors of the skull base, extending into the orbit, paranasal sinuses, nasal cavity, pterygopalatine and infratemporal fossae. Zh Vopr Neirokhir im N N Burdenko. 2013;5:3-15. (In Russ.).
Gardner PA, Kassam AB, Thomas M, Snyderman CH, Carrau RL, Mintz AH, Prevedello DM. Endoscopic endonasal resection of anterior cranial base meningiomas. Neurosurgery. 2008;63(1):36-54. doi:10.1227/01.NEU.0000335069.30319.1E
Koutourousiou M, Fernandez-Miranda JC, Wang EW, Snyderman CH, Gardner PA. Endoscopic endonasal surgery for olfactory groove meningiomas: outcomes and limitations in 50 patients. Neurosurg Focus. 2014;37(4):E8. doi:10.3171/2014.7.FOCUS14330
Hadad G, Bassagasteguy L, Carrau RL, Mataza JC, Kassam A, Snyderman CH, Mintz A. A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope. 2006;116(Oct):1882-1886. doi:10.1097/01.mlg.0000234933.37779.e4
Fliss DM, Abergel A, Cavel O, Margalit N, Gil Z. Combined subcranial approaches for excision of complex anterior skull base tumors. Arch Otolaryngol Head Neck Surg. 2007;133(9):888-896. doi:10.1001/archotol.133.9.888
Har-El G, Todor R. Endoscopic craniofacial approach for intracranial polyposis: the «blue-sky technique». Skull Base. 2003;13(4):235-239. doi:10.1055/s-2004-817700
Har-El G, Casiano RR. Endoscopic management of anterior skull base tumors. Otolaryngol Clin North Am. 2005;38(1):133-144. doi:10.1016/j.otc.2004.09.007
Lund VJ, Howard D. External versus endoscopic approaches for skull base malignancies. In: Stamm A, eds. Transnasal Endoscopic Skull Base and Brain Surgery. Tips and Pearls. New York: Thieme medical publishers Inc. 2011;355-358.
Goel A, Moiyadi A. Evolved craniofacial surgery. World Neurosurg. 2012;78(1-2):62-63. doi:10.1016/j.wneu.2011.11.007
Sekhar LN, Tariq F, Ferreira M. What is the best approach to resect an anterior midline skull base meningioma in 2011? Microsurgical transcranial, endonasal endoscopic, or minimal access cranial? World Neurosurg. 2012;77(5-6):621-622. doi:10.1016/j.wneu.2011.10.013