Lateral suboccipital retrosigmoid retrocondylar approach for foramen magnum meningiomas

Objective: The objective of the study was to describe our approach and the surgical technique and analyze its safety and the outcome for foramen magnum meningiomas (FMMs). Methods: From 1986 to 2016, 15 FMM patients were operated on using the lateral suboccipital retrocondylar approach. Results: In this series, there were 12 (80%) female and 3 (20%) male patients. The patients ranged in age from 33 to 63 years. There was no operative dead, but two patients died during the follow-up period, which varied from 1 to 24 years (mean, 10.2 years). Twelve patients (80%) achieved Glasgow Outcome Scale 4 or 5. Gross total resection was achieved in 13 (86.6.7%) patients. Conclusions: The majority of FMM can be safely removed using the lateral suboccipital retrocondylar approach without condylar resection, associated to meticulous microsurgical technique

The extended pterional approach allows excellent results for removal of anterior cranial fossa meningiomas

ABSTRACT Objective To describe a unique operative strategy, instead the classical pterional approach, and to analyses it safety and effectiveness for removal of anterior cranial fossa meningiomas. Method We identify 38 patients with tuberculum sellae and olphactory groove meningiomas operated between 1986 and 2013. Medical charts, operative reports, imaging studies and clinical follow-up evaluations were reviewed and analyzed retrospectively. The pterional craniotomy is extended toward the frontal bone providing access through the subfrontal route, besides the usual anterolateral view provided by the classical pterional approach. Results Surgical mortality occurred in one patient (2.6%). Gross total resection was achieved in 27 patients (86.8%). Median time of follow-up was 69.4 months. Conclusion The extended pterional approach allows excellent results. Total removal of meningiomas of the anterior cranial fossa was obtained in 86.8 % of patients, with low morbidity and mortality