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Endoscopic endonasal versus transcranial approach to resection of olfactory groove meningiomas: a systematic review

  • Aarti Purohit
  • Roshani Jha
  • Adham M. Khalafallah
  • Carrie Price
  • Nicholas R. Rowan
  • Debraj MukherjeeEmail author
Review

Abstract

Despite the increasing utility of the endoscopic endonasal approach (EEA) for management of anterior skull base (ASB) pathologies, the optimal treatment strategy for olfactory groove meningiomas (OGM) remains unclear. This project sought to systematically compare outcomes of EEA management with conventional transcranial approach (TCA) for the treatment of OGMs. A systematic review was performed to identify studies that compared outcomes following EEA and TCA for OGMs. Data extracted from each study included gross total resection (GTR), incidence of cerebrospinal fluid (CSF) leaks, and post-operative complications including anosmia. The results of the search yielded 5 studies which met the criteria for inclusion and analysis. All studies compared TCA (n = 922) with EEA (n = 141) outcomes for OGMs. Overall, the rate of gross total resection (GTR) was lower among the endoscopic group (70.9%) relative to the transcranial group (91.5%). The rate of post-operative CSF leak was 6.3% vs. 25.5% for the transcranial and endoscopic groups, respectively. Post-operative anosmia was higher for patients undergoing EEA (95.9%) compared with patients in the transcranial group (37.4%). In this analysis, EEA was associated with a lower rate of GTR and higher incidences of CSF leaks and post-operative anosmia. However, with increasing surgeon familiarity of the endoscopic anatomy and technique for managing ASB pathologies, a nuanced approach may be used to minimize patient morbidity and widen the spectrum of skull base surgery.

Keywords

Craniotomy Endoscopy Meningioma Olfactory groove Skull base 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Only published studies were used for our analysis, and no patient medical records were accessed in completing this article. Thus, patients’ consent was not required.

Supplementary material

10143_2019_1193_MOESM1_ESM.pdf (60 kb)
ESM 1 Supplemental Digital Content [1]. Methods. Appendix A. The search strategy in PubMed, Embase, Cochrane, Web of Science, Scopus, CINAHL, and ClinicalTrials.gov (PDF 60 kb)

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Copyright information

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

Authors and Affiliations

  1. 1.Johns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Johns Hopkins UniversityBaltimoreUSA
  3. 3.Department of NeurosurgeryJohns Hopkins University School of MedicineBaltimoreUSA
  4. 4.Department of Otolaryngology-Head and Neck SurgeryJohns Hopkins University School of MedicineBaltimoreUSA

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