Endoscopic transnasal resection of clival meningiomas

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BACKGROUND

Surgical treatment of ventral and ventrolateral meningiomas of posterior cranial fossa is difficult in modern neurosurgery. This is due to peculiarities of approach to these areas and concentration of critical structures (cranial nerves and great vessels). Currently, endoscopic transnasal approach to these meningiomas allows partial, and in some cases, total resection. However, this technique is not widespread.

OBJECTIVE

To analyze the world literature data on postoperative outcomes in patients with clival and petroclival meningiomas after endoscopic transnasal resection.

MATERIAL AND METHODS

We analyzed 22 articles representing treatment of 61 patients with clival and petroclival meningiomas.

RESULTS

Total or near-total resection was achieved in 22.9% of cases, subtotal resection — 40.9%, partial resection — 26.2% (data were not provided in other cases). Even partial and subtotal resection leads to significant regression of symptoms.

CONCLUSION

Endoscopic transnasal surgery is a full-fledged alternative to transcranial approaches in surgical treatment of clival meningiomas. It is also an additional option for patients with petroclival meningiomas after ineffective transcranial approaches. Transnasal tumor shrinkage and devascularization lead to brainstem decompression, regression of hydrocephalus and baseline clinical symptoms.

Keywords:

meningioma of posterior cranial fossa

endoscopic transnasal access

Authors:

Shkarubo A.N.

Burdenko Neurosurgical Center

ORCID: 0000-0003-3445-3115

Chernov I.V.

Burdenko Neurosurgical Center

ORCID: 0000-0002-9789-3452

Veselkov A.A.

Burdenko Neurosurgical Center

ORCID: 0000-0003-2500-3403

Andreev D.N.

Burdenko Neurosurgical Center

ORCID: 0000-0001-5473-4905

Yakupova Z.F.

Peoples’ Friendship University of Russia

ORCID: 0009-0001-8525-4223

Kalinin P.P.

Burdenko Neurosurgical Center

ORCID: 0000-0001-9333-9473

Received:

26.10.2023

Accepted:

12.01.2024

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