Endoscopic Endonasal Approach for Meningiomas

The endoscopic endonasal approach (EEA) for treating meningiomas has unique advantages over traditional surgery: 

Minimally Invasive Surgery:
The EEA uses the nostrils and nasal cavity as a natural corridor to the base of the skull, avoiding the need for skin incisions and cranial openings.

Early Tumor Devascularization:
The vascular supply to the tumor originates mostly from the base of the skull, and using the EEA, it can be interrupted before entering the tumor.

Direct Access to Tumor Origin:
The EEA provides direct access to the tumor origin without any manipulation of the brain, vessles, or cranial nerves.

Minimizing Complications:
A less invasive but more direct access with no manipulation of neural structures and early tumor devascularization produces better clinical results with shorter recovery times. 

The endonasal endoscopic approach can be used to treat the following meningiomas:

 

Olfactory Groove Meningioma - tumors that grow along the midline floor of the anterior cranial fassa.

Suprasellar Meningioma - tumors that arise from the base of the skull near the pituitary gland and the optic nerve.

Petroclival Meningioma - tumors that originate in the upper two thirds of the clivus.

 

Case Study: Suprasellar (Tuberculum Sellae) Meningioma

36-year-old woman with visual loss underwent EEA with complete tumor resection, significant visual improvement, and fast recovery. The EEA avoided any manipulation of the optic nerves and facilitated complete tumor resection. 

Pre-Op:


10 Days Post-Op:

Case Study: Petroclival Meningioma

61-year-old woman presenting with difficulty walking and swallowing problems underwent near-total resection of this challenging tumor, with complete improvement after surgery. She had transient double vision that recovered in 3 months, and the residual tumor was treated with radiosurgery with excellent response 6 years after surgery.