Полностью эндоскопическое транскраниальное удаление менингиомы основания передней черепной ямки с использованием мини-птерионального keyhole-доступа у пациента с выраженной пневматизацией лобной пазухи: клиническое наблюдение

Transcranial surgery of skull base meningiomas currently remains the main method of treatment. Transnasal removal is possible in a number of cases, but it is associated with the risk of postoperative CSF-leak as a result of insolvency of the reconstruction of the skull base defect. Minimally invasive (keyhole) accesses provide a tumor overview comparable to standard accesses in most cases. The anterior-medial part of the anterior cranial fossa and the olfactory fossa is not accessible to the direct view from the minipterional craniotomy. The use of angular endoscopic optics in combination with additional resection or thinning of the bones in the orbital roof provides an overview sufficient to remove the tumor, but manipulations in this area require the use of specific tools. Aspirators, dissectors and coagulators should have bends of different expressions. The application of the described technique is advisable only in certain specially selected cases.