The endoscopic endonasal approach or microscopic transcranial approach for anterior skull base meningiomas—It is all about right indication rather than superiority

  • David Monterroso Cohen
  • Hamid Borghei-Razavi
  • Varun R. Kshettry
  • Pablo F. RecinosEmail author
Letter to the editor - Tumor - Meningioma
Part of the following topical collections:
  1. Tumor – Meningioma

Dear Editor,

We have read the review article entitled “The endoscopic endonasal approach is not superior to the microscopic transcranial approach for anterior skull base meningiomas—a meta-analysis” by Ivo S. Muskens et al, published in Acta Neurochirugica (2018) 160:59–75 [10]. We want to congratulate the authors for their efforts in taking on this polemic topic and offer some observations.

The authors conducted a systematic review and meta-analysis of the literature from 2004 to 2016 comparing outcomes between an endonasal transsphenoidal approach (eTSA) and a microsurgical transcranial approach (mTCA) for tuberculum sellae meningiomas (TSMs) and olfactory groove meningiomas (OGMs). Outcome variables included gross total resection (GTR), visual improvement, cerebrospinal fluid (CSF) leak, intraoperative arterial injury, and mortality.

Of 1648 studies, they reported that the CSF leak was significantly higher among eTSA patients for both OGM and TSM (eTSA 25.1% vs. mTCA 10.5%, p...



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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Section of Skull Base Surgery, Department of NeurosurgeryCleveland ClinicClevelandUSA
  2. 2.Minimally Invasive Cranial Base and Pituitary Surgery Program, Rose Ella Burkhart Brain Tumor and Neuro-oncology CenterCleveland ClinicClevelandUSA
  3. 3.Pauline Braathen Neurological Center, Department of NeurosurgeryCleveland Clinic FloridaWestonUSA

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