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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2016; 74(05): 382-387
DOI: 10.1590/0004-282X20160058
ARTICLE

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

O acesso pterional extendido permite excelente resultado para a ressecção dos meningiomas da fossa craniana anterior
Jose Carlos Lynch
1   Rede D’Or São Luiz, Rio de Janeiro RJ, Brasil;
,
Mariangela Barbi Gonçalves
1   Rede D’Or São Luiz, Rio de Janeiro RJ, Brasil;
,
Celestino Esteves Pereira
2   Hospital Federal dos Servidores do Estado do Rio de Janeiro, Serviço de Neurocirugia, Rio de Janeiro RJ, Brasil.
,
Wladimir Melo
2   Hospital Federal dos Servidores do Estado do Rio de Janeiro, Serviço de Neurocirugia, Rio de Janeiro RJ, Brasil.
,
Gianni Ferraz Temponi
2   Hospital Federal dos Servidores do Estado do Rio de Janeiro, Serviço de Neurocirugia, Rio de Janeiro RJ, Brasil.
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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.

RESUMO

Objetivo Descrever a craniotomia pterional estendida, ao invés da abordagem pterional clássica, e analisar sua segurança e eficácia para a remoção dos meningiomas da fossa anterior.

Método Identificamos 38 pacientes com meningiomas do tubérculo da sela e da goteira olfatória operados entre 1986 e 2013. Os prontuários, relatórios cirúrgicos, exames de imagem e acompanhamento pós-operatório foram analisados retrospectivamente. A craniotomia pterional com extensão para o osso frontal permite acesso pela via subfrontal além da via anterolateral do acesso pterional clássico.

Resultados A mortalidade cirúrgica foi de 2,6% (um paciente). A remoção total foi alcançada em 86,8% (27 pacientes) com um tempo médio de seguimento de 69,4 meses.

Conclusão A abordagem pterional estendida permite excelentes resultados. A remoção total dos meningiomas da fossa craniana anterior foi obtida em 86,8% dos pacientes, com baixa morbi-mortalidade.

meningiomas - cranal fossa - anterior - microsurgery
meningiomas - fossa cranial anterior - microcirurgia


Publication History

Received: 21 October 2015

Accepted: 09 December 2015

Article published online:
06 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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